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dc.contributor.authorJohansen, Tonje Okkenhaug
dc.contributor.authorSundseth, Jarle Østberg
dc.contributor.authorFredriksli, Oddrun
dc.contributor.authorAndresen, Hege
dc.contributor.authorZwart, John-Anker
dc.contributor.authorKolstad, Frode
dc.contributor.authorPripp, Are Hugo
dc.contributor.authorGulati, Sasha
dc.contributor.authorNygaard, Øystein Petter
dc.date.accessioned2022-03-09T12:14:04Z
dc.date.available2022-03-09T12:14:04Z
dc.date.created2021-08-05T19:53:57Z
dc.date.issued2021
dc.identifier.citationJAMA Network Open. 2021, .en_US
dc.identifier.issn2574-3805
dc.identifier.urihttps://hdl.handle.net/11250/2984024
dc.description.abstractSurgical treatment for cervical radiculopathy is increasing. Treatment with motion preserving anterior cervical disc arthroplasty was introduced to prevent symptomatic adjacent segment disease, and there is need to evaluate results of this treatment compared with standard anterior cervical discectomy and fusion. Objective To investigate clinical outcomes at 5 years for arthroplasty vs fusion in patients who underwent surgical treatment for cervical radiculopathy. Design, Setting, and Participants This multicenter, single-blinded, randomized clinical trial included patients aged 25 to 60 years with C6 or C7 radiculopathy referred to study sites’ outpatient clinics from 2008 to 2013. Data were analyzed from December 2019 to December 2020. Interventions Patients were randomly assigned to arthroplasty or fusion. Patients were blinded to which treatment they received. The surgical team was blinded until nerve root decompression was completed. Main Outcomes and Measures The primary end point was change in Neck Disability Index (NDI) score. Secondary outcomes were arm and neck pain, measured with numeric rating scales (NRS); quality of life, measured with the EuroQol-5D (EQ-5D); reoperation rates; and adjacent segment disease. Results Among 147 eligible patients, 4 (2.7%) declined to participate and 7 (4.8%) were excluded. A total of 136 patients were randomized (mean [SD] age, 44.1 [7.0] years; 73 (53.7%) women), with 68 patients randomized to arthroplasty and 68 patients randomized to fusion. A total of 114 patients (83.8%) completed the 5-year follow-up. In the arthroplasty group, the mean NDI score was 45.9 (95% CI, 43.3 to 48.4) points at baseline and 22.2 (95% CI, 18.0 to 26.3) points at 5 years follow-up, and in the fusion group, mean NDI score was 51.3 (95% CI, 48.1 to 54.4) points at baseline, and 21.3 (95% CI, 17.0 to 25.6) points at 5 years follow-up. The changes in mean NDI scores between baseline and 5 years were statistically significant for arthroplasty (mean change, 24.8 [95% CI, 19.8 to 29.9] points; P < .001) and fusion (mean change, 29.9 [95% CI, 24.0 to 35.9] points; P < .001), but the change in mean NDI scores was not significantly different between groups (difference, 5.1 [95% CI, −2.6 to 12.7] points; P = .19). There were no significant differences in changes in arm pain (mean [SE] change, 3.5 [0.5] vs 3.1 [0.4]; P = .47), neck pain (mean [SE] change, 3.0 [0.5] vs 3.4 [0.5]; P = .50), EQ-5D (mean [SE] change, 0.39 [0.4] vs 0.45 [0.6]; P = .46), patients requiring reoperation (10 patients [14.7%] vs 8 patients [11.8%]; P = .61), and adjacent segment disease (0 patients vs 1 patient [1.5%]; P = .32) between the arthroplasty and fusion groups. Conclusions and Relevance In this randomized clinical trial, patients treated with arthroplasty and fusion reported similar and substantial clinical improvement at 5 years. Trial Registration ClinicalTrials.gov Identifier: NCT00735176en_US
dc.language.isoengen_US
dc.publisherAmerican Medical Associationen_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.titleEffect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy: A Randomized Clinical Trialen_US
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.description.versionpublishedVersionen_US
dc.source.pagenumber12en_US
dc.source.journalJAMA Network Openen_US
dc.identifier.doi10.1001/jamanetworkopen.2021.19606
dc.identifier.cristin1924251
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1


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