Impact of Cervical Disc Arthroplasty vs Anterior Cervical Discectomy and Fusion on Driving Disability: Post Hoc Analysis of a Randomized Controlled Trial With 10-Year Follow-Up

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Figure 1
Mean driving disability scores in cervical disc arthroplasty (CDA) vs anterior cervical discectomy (ACDF) and fusion patients over time. P values represent the results of Wilcoxon rank-sum test comparing treatment groups.
Download figure
Open in new tab
Download powerpoint
Figure 2
Summary and comparison of driving disability severity groups in cervical disc arthroplasty (CDA) vs anterior cervical discectomy and fusion (ACDF) patients over time. P values represent the results of the Fisher exact test.

Table 1

Driving subsection of Neck Disability Index questionnaire.

Score	Driving
0	I can drive my car without any neck pain.
1	I can drive my car as long as I want with slight pain in my neck.
2	I can drive my car as long as I want with moderate pain in my neck.
3	I can’t drive my car as long as I want because of moderate pain in my neck.
4	I can hardly drive at all because of severe pain in my neck.
5	I can’t drive my car at all.

Table 2

Summary and comparison of driving disability score improvement from preoperative score over time.

Timepoint	Cervical Disc Arthroplasty (N = 209)	Anterior Cervical Discectomy and Fusion (N = 188)	P ^a
6 wk	−1.44 ± 1.44	−0.88 ± 1.68	<0.001
3 mo	−1.76 ± 1.25	−1.61 ± 1.18	0.103
6 mo	−1.94 ± 1.23	−1.68 ± 1.22	0.016
1 y	−1.98 ± 1.22	−1.68 ± 1.16	0.006
2 y	−1.96 ± 1.15	−1.75 ± 1.21	0.032
3 y	−1.94 ± 1.22	−1.68 ± 1.24	0.007
5 y	−2.01 ± 1.17	−1.57 ± 1.38	<0.001
7 y	−1.92 ± 1.26	−1.61 ± 1.31	0.004
10 y	−1.94 ± 1.22	−1.63 ± 1.39	0.003

aP values were from a generalized linear model adjusted from preoperative score as the covariate.

Table 3

Summary and comparison of driving disability severity groups over time.

Timepoint	Severity Group	Cervical Disc Arthroplasty (N = 209)	Anterior Cervical Discectomy and Fusion (N = 188)	P ^a
Preoperative	None	2/209 (1.0%)	1/188 (0.5%)	0.968
	Mild	88/209 (42.1%)	78/188 (41.5%)
	Severe	119/209 (56.9%)	109/188 (58.0%)
6 wk	None	67/204 (32.8%)	42/179 (23.5%)	0.001
	Mild	106/204 (52.0%)	83/179 (46.4%)
	Severe	31/204 (15.2%)	54/179 (30.2%)
3 mo	None	94/202 (46.5%)	67/177 (37.9%)	0.217
	Mild	87/202 (43.1%)	91/177 (51.4%)
	Severe	21/202 (10.4%)	19/177 (10.7%)
6 mo	None	113/203 (55.7%)	79/171 (46.2%)	0.014
	Mild	77/203 (37.9%)	66/171 (38.6%)
	Severe	13/203 (6.4%)	26/171(15.2%)
1 y	None	119/202 (58.9%)	78/164 (47.6%)	0.068
	Mild	66/202 (32.7%)	64/164 (39.0%)
	Severe	17/202 (8.4%)	22/164 (13.4%)
2 y	None	113/197 (57.4%)	78/157 (49.7%)	0.180
	Mild	69/197 (35.0%)	59/157 (37.6%)
	Severe	15/197 (7.6%)	20/157 (12.7%)
3 y	None	110/183 (60.1%)	68/146 (46.6%)	0.044
	Mild	59/183 (32.2%)	60/146 (41.1%)
	Severe	14/183 (7.7%)	18/146 (12.3%)
5 y	None	105/166 (63.3%)	56/134 (41.8%)	<0.001
	Mild	50/166 (30.1%)	59/134 (44.0%)
	Severe	11/166 (6.6%)	19/134 (14.2%)
7 y	None	94/153 (61.4%)	53/120 (44.2%)	0.014
	Mild	46/153 (30.1%)	49/120 (40.8%)
	Severe	13/153 (8.5%)	18/120 (15.0%)
10 y	None	89/144 (61.8%)	47/114 (41.2%)	0.003
	Mild	46/144 (31.9%)	51/114 (44.7%)
	Severe	9/144 (6.3%)	16/114 (14.0%)