A Comparative Study between Anterior Cervical Discectomy with fusion and Cervical Total Disc Replacement for the Treatment of Cervical Disc Disease

ACDF has been for a long time the gold standard for the treatment of CDDD. This procedure showed excellent relief of pain and neurologic deficits. However, there has been some concern about the effect of fusion on the adjacent segment degeneration. As a result, there has been a recent increase in interest in TDR and its potential to maintain motion at the operative level while minimizing the development of adjacent segment degeneration.Fifty patients of CDDD were enrolled into the study. Patients were divided into 2 groups, 25 patients each. One group was treated by cervical TDR and the other was treated by ACDF. A retrospective study was performed on 20 patients in Neurocenter, Liberec, Czech Republic. A prospective study was performed on 30 patients, with 15 procedures performed in Neurocenter and 15 procedures performed in Zagazig University Hospitals.Cervical TDR, as well as ACDF, is a successful procedure in relieving pain and neurologic deficit.A long term follow-up is required for such a study to detect the effect of cervical TDR on the adjacent discs and their potential degeneration.The most frequent complication reported in the TDR group was the HO. The incidence of HO can be decreased by proper selection of the patients with younger age and soft disc herniation and avoid those with more degenerative changes.