74. Cervical disc arthroplasty for axial neck pain: outcomes up to seven years

BACKGROUND CONTEXT Cervical disc arthroplasty (CDA) is a proven, effective treatment for degenerative disc disease with radiculopathy and/or myelopathy. There is, however, little published evidence of the effectiveness of CDA in relieving pain and improving function in patients with a primary diagnosis of axial neck pain. PURPOSE This study compares the outcomes of patients who underwent CDA for 3 conditions: predominant axial neck pain (ANP), predominant radiculopathy (RAD), or a combination of both (ANP+RAD). STUDY DESIGN/SETTING We present an analysis of prospectively collected data for patients at a single site who underwent CDA at one or more levels from C3-C7 for ANP, RAD, or ANP+RAD. PATIENT SAMPLE From 2003 to 2018, 782 consecutive patients underwent CDA: 257 ANP, 330 RAD, and 195 ANP+RAD. OUTCOME MEASURES Patient-reported outcomes (PROs) included Neck Disability Index (NDI), Veterans RAND VR-12 Physical Component Summary (PCS) and Mental Component Summary (MCS), numerical rating scales (intensity + frequency: 0-20) for neck pain and arm pain. The number of patients who underwent a reoperation and length of time to reoperation were also recorded. METHODS Mixed effect regression models predicted scores at all postoperative intervals, including an intercept and adjustment for diagnosis group, time point, and if statistically significant at the 0.05 level, number of operative levels, with additional adjustments for demographic characteristics including age at surgery, gender, and BMI. RESULTS The surgeries performed were 40.8% 1-level, 41.6% 2-level, 14.7% 3-level, and 2.9% 4-level. The number of operative levels was statistically different between the three groups (p CONCLUSIONS Appropriately selected patients with predominant axial neck pain treated with CDA may achieve improvements in clinical and functional outcomes comparable to patients with a primary diagnosis of predominant radiculopathy, or of axial neck pain with concomitant radiculopathy. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.