Return to Work Faster After Cervical Disc Arthroplasty vs. ACDF

A study by Jeffrey J. Larson, MD showed that patients treated with cervical disc arthroplasty return to work faster than those treated with cervical fusion.  The study was presented at the International Society for the Advancement of Spine Surgery 2015 Annual Meeting.

Cervical disc arthroplasty and anterior cervical discectomy and fusion are both accepted treatment options for cervical disc herniation with radiculopathy.  Comparisons of both procedures have generally centered on neurologic outcomes and reoperation rates.  This study compares the return to work rate after both surgeries.

20 workers compensation patients underwent either ACDF or cervical disc arthroplasty for disc herniation and/or spondylosis (bone spurring) with neck pain and radiculopathy (arm pain, numbness, and/or weakness).  Jeffrey J. Larson, MD, Coeur d’Alene Spine and Brain, Coeur d’Alene, Idaho was the surgeon for every patient.

  • 8 of the 20 patients had single level cervical disc arthroplasty
  • 8 of the 20 patients had single level ACDF
  • 4 of the 20 patients had 2 level ACDF.

The study measured Neurologic function, Oswestry Disability Index (perceived disability), and return to work rates in every patient.

Results:

All patients had normal neurologic function at follow-up.

All patients had improvement in their ODI at follow-up.  The average improvement rates were 52.6% for disc arthroplasty cases, 45% for single-level ACDF cases, and 52% for 2 level ACDF cases.

Return to work rates were 40.5 days for disc arthroplasty cases, 96 days for single-level ACDF cases, and 105 days for 2 level ACDF cases.

Conclusion:

ACDF and cervical disc arthroplasty offer excellent outcomes for cervical disc herniation and/or spondylosis with radiculopathy.  These procedures generally return patients to normal function and regular activities with improvement in perceived disability.  Cervical disc arthroplasty  has the benefit of return to regular activities much sooner.  This significantly decreases the time it takes to return to work after surgery and decreases time loss in workers compensation cases.