Adjacent segment degeneration incidence uninfluenced by Total Disc Arthroplasty .
This report has been verified
by one or more authors of the
original publication.
تم تحديد هذه الدراسة على أنها ذات تأثير كبير محتمل.
يُقدّر مقياس التأثير العالي الذي يعتمد على الذكاء الاصطناعي من OE التأثير المحتمل لورقة بحثية ما من خلال دمج الإشارات من كل من المجلة التي نُشرت فيها والمحتوى العلمي للمقالة نفسها.
تم تطوير نموذج OE High Impact باستخدام أحدث تقنيات معالجة اللغة الطبيعية، ويتنبأ نموذج OE High Impact بدقة أكبر بأداء الاقتباس المستقبلي للدراسة أكثر من معامل تأثير المجلة وحده.
وهذا يتيح التعرف المبكر على الأبحاث ذات المغزى السريري ويساعد القراء على التركيز على المقالات التي من المرجح أن تشكل الممارسة المستقبلية.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(8):23 Spine Journal; 2010; 10; 1043-104893 patients, with mono or bi-level cervical disc symptomatic disease and upon failure of conservative treatment, were randomized to undergo total disc arthroplasty (TDA) or anterior cervical discectomy and fusion (ACDF). Primary Outcome Measures were Visual Analogue Score (VAS), Neck Disability Index and Radiographic Assessment were made at different time points until 48 months. Both the ACDF and TDA procedures were found to be equivalent for rendering pain relief in both mono and bi level disc disease and had equivalent risks for inducing adjacent segment degeneration. Interestingly, it was observed that patients with concurrent degenerative disc disease of the lumbar spine had greater likelihood of developing adjacent segment degeneration.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
نعم = 1
غير مؤكد = 0.5
غير ذي صلة = 0
لا = 0
يقيّم تقييم معايير الإبلاغ الشفافية التي يبلغ بها المؤلفون عن الخصائص المنهجية والتجريبية للتجربة في المنشور. ينقسم التقييم إلى خمس فئات معروضة أدناه.
3/4
Randomization
3/4
Outcome Measurements
1/4
Inclusion / Exclusion
4/4
Therapy Description
3/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
مؤشر الهشاشة هو أداة تساعد في تفسير النتائج المهمة، وتوفر مقياسًا لقوة النتيجة. ويمثل مؤشر الهشاشة عدد الأحداث المتتالية التي يجب إضافتها إلى نتيجة ثنائية التفرع لجعل النتيجة غير مهمة. يمثل الرقم الصغير نتيجة أضعف ويمثل الرقم الكبير نتيجة أقوى.
لماذا كانت هناك حاجة لهذه الدراسة الآن؟
Anterior cervical discectomy and fusion (ACDF) is an established treatment for the degenerative disc disease of the cervical spine; however, the development of implants and procedures to restore motion, segmental anatomy, and function shows success after further investigation. The purpose of this study was to compare the incidence of adjacent segment disease in patients treated for degenerative disc disease with either total disc arthroplasty or anterior cervical discectomy and fusion.
ما هو سؤال البحث الرئيسي؟
Is there a difference in incidence of adjacent segment disease after patients with degenerative disc disease are treated with either total disc arthroplasty or anterior cervical discectomy and fusion?
- The success rates were similar in procedures, 71% in TDA and 73.5% in ACDF, and median symptom-free survival period was 39.79+/-1.9 months for ACDF and 38.09+/- 1.9 months for TDA patients. Smokers had a trend towards worse survival rates (p=0.17) for both procedures.
- VAS and NDI scale were similar between groups (p-value = 0.693)
- No statistical difference was noted between groups in terms of development of adjacent lumbar disease (p-value = 0.885)
- Presence of documented lumbar disease was a statistically significant risk factor for development of adjacent lumbar disease (p-value = 0.016)
ما الذي يجب أن أتذكره أكثر؟
Total disc arthroplasty and anterior cervical discectomy and fusion have the same clinical outcomes. However, lumbar disease increases the risk of adjacent cervical degenerative disc disease.
كيف سيؤثر ذلك على رعاية مرضاي؟
This study suggests that both techniques are equivalent in treating degenerative disc disease and do not increase risk of adjacent lumbar disease compared to one another. The study also notes that lumbar disease is a significant risk factor for development of adjacent cervical degenerative disc disease. Therefore, it is recommended that physicians consider other factors before considering which treatment is most appropriate for patients.
تنويه
هذا المحتوى الموجود في هذه الصفحة هو لأغراض إعلامية فقط وليس الغرض منه أن يكون بديلاً عن المشورة الطبية المتخصصة أو التشخيص أو العلاج. إذا كنت بحاجة إلى علاج طبي، اطلب دائمًا مشورة طبيبك أو اذهب إلى أقرب قسم طوارئ إليك. الآراء والمعتقدات ووجهات النظر التي يعبر عنها الأفراد في المحتوى الموجود في هذه الصفحة لا تعكس آراء ومعتقدات ووجهات نظر أورثوإيفيدنس.
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