Cervical disc arthroplasty: What we know in 2020 and a literature review

Cervical disc arthroplasty (CDA) is a safe and effective option to improve clinical outcomes (e.g., NDI, VAS, and JOA) in degenerative cervical disc disease and compressive myelopathy. CDA’s two main purported benefits have been that it maintains physiologic motion and thereby minimizes the biomechanical stresses placed on adjacent segments as compared to an ACDF. CDA might reduce the degeneration of adjacent segments, and the need for adjacent-level surgery. Reoperation rates of CDA have been reported to range from 1.8% to 5.4%, with a minimum 5-year follow-up. As the number of CDA procedures performed continues to increase, the need for revision surgery is also likely to increase. When performed skillfully in appropriate patients, CDA is an effective surgical technique to optimize clinical outcomes and radiological results. This review may assist surgical decision-making and enable a more effective and safer implementation of cervical arthroplasty for cervical degenerative disease.

Outcome analysis of upper and lower limb motor functions after anterior cervical discectomy and fusion for degenerative cervical disc disease

Background: Anterior cervical discectomy and fusion (ACDF) is the most commonly performed surgical procedure for symptomatic cervical disc disease. In this study, we analysed the upper and lower limb motor functions after ACDF for disc prolapse in patients with degenerative cervical disc disease. Methods: One hundred consecutive adult patients who underwent ACDF for single or two-level cervical disc prolapse during the study period (October 2015 to October 2017) were included in the study. Results: Preoperative motor deficits in limbs were noted in 73% (73/100) of the patients. Enhance recovery of motor deficits was noted in 72.6% (53/73) of these patients and persisting motor deficits in the remaining patients (20/73- 27.4%). Five patients (5/27- 18.5%) without any preoperative motor deficits developed motor deficits after ACDF. Detailed pre and postoperative (at the time of discharge) motor power (graded by MRC grade) in all 4 limbs (Shoulder abduction/adduction/flexion/extension, elbow flexion/extension, wrist flexion/extension, hip abduction/adduction/flexion/extension, knee flexion/extension, ankle flexion/extension) was recorded. Statistically significant improvement in motor power (as recorded at the time of discharge) was noted in all the tested muscle groups after ACDF. Conclusion: Early improvement in preoperative motor deficits can be expected in the majority of the patients with cervical PIVD following ACDF.

Pattern of Musculo-Skeletal Disorders in Diabetic and Non-diabetic Patients Attending in a Tertiary Care Hospital in Dhaka

Background: Disorders of the musculoskeletal (MSK) system affect all ages and ethnic groups. This study was done to see the pattern of MSK disorders in diabetic and non-diabetic patients at a tertiary care hospital.Methods: This cross-sectional study was done between period of June 2016-Feb 2017 in the Department of Physical Medicine and Rehabilitation of a tertiary care hospital in Dhaka. Six hundred individuals were included in the study, 300 in diabetic and 300 in non-diabetic group.Results: Diabetic group consisted with 95 (31.67%) males, 205 (68.33%) females. Non-diabetic group consisted with 176 (58.67%) males and 124 (41.33%) females. Osteoarthritis knees (CoA of (101, 33.67%), degenerative lumber disc disease (69, 23%), frozen shoulder (60, 20%), degenerative cervical disc disease (42, 14%) and non-specific back pain (22, 7.3%), were common among diabetic patients. Among non- diabetic patients nonspecific back pain (55, 18.33%), degenerative lumbar disc disease (52, 17.33%), degenerative cervical disc disease (41, 13.66%), OA of knees (38, 12.60%), prolapsed lumbar inter- vertebral disc (PLID) (30, 10%) were common.Conclusion: Degenerative, non-inflammatory abnormalities comprised the major bulk of problems. Soft tissue rheumatism was common in diabetic patients. Frozen shoulder was present in higher percentage in diabetic patients.Birdem Med J 2018; 8(1): 68-71