Anterior cervical discectomy and fusion for radiculopathy and myelopathy has the complication of the development of adjacent segment degeneration. Furthermore, reoperations may be required to treat complications of fusion, such as non-union, graft collapse, or expulsion. Cervical disc arthroplasty lays claim to preserving cervical motion and reducing the risks of adjacent segment disease in the treatment of cervical radiculopathy.

We performed a prospective study in order to evaluate the radiological and clinical outcomes of cervical disc arthroplasty for single or two level disc disease with associated radiculopathy. Our study included a total of 26 patients. Each patient had cervical radiculopathy from nerve root compression due to degenerative disc disease at one or two levels. Diagnosis was made preoperatively on clinical examination and by means of MRI scanning. Each patient also had preoperative flexion and extension cervical spine x-rays in order to assess pre-operative range of neck movement.

The outcomes of surgery were assessed prospectively. Range of motion at final follow-up was measured by flexion and extension view x-rays of the cervical spine. Clinical outcome was assessed by means of VAS scores for pain, SF12 for mental and physical health and the neck disability index (NDI). All complications were recorded. 14 of the patients had a follow-up for two years and the remaining 12 patients had a follow-up for one year.

A Discovery disc arthoplasty by Scient'X was the implant used in all patients. A standard anterior cervical approach was used to achieve decompression and for the implantation of the prosthesis.

On follow-up all patients had either maintenance or an improvement in the range of movement. There was no evidence of progression of degeneration in the segments adjacent to the arthroplasty prosthesis. Improvements in SF12, VAS, and NDI scores were seen from preoperative levels in 25 of the 26 patients. Complications included one patient with a horse voice post-operatively and one patient with minimal improvement of radicular symptoms. Post-operative MRI scanning demonstrated adequate decompression with this procedure and showed no evidence of progression of adjacent segment disease. There were no cases of implant subsidence or dislocations.

We have found cervical disc arthroplasty to produce good clinical outcomes when used for single or two level cervical radiculopathy whilst maintaining neck motion with an acceptable complication rate. A longer follow-up is needed to further assess the risk of development of adjacent segment disease but we did not discover the development of adjacent segment disease in our study with a follow-up of upto 2 years

Study design: Prospective cohort study.

Objective: To investigate association between recovery from low back pain (LBP) and body mass index (BMI) in patients with LBP undergoing physiotherapy.

Introduction: The relationship between obesity and LBP has long been debated. There are no published studies examining the influence of BMI on recovery from LBP.

Methods: One hundred and forty patients with chronic LBP and no neurological deficit underwent a back-specific physiotherapy programme. BMI and recovery parameters such as pain intensity (visual analogue scale scores), and self-experienced impairment and disability scores were measured. The range of motion of the lumber spine was also recorded. These variables were compared pre and post treatment. Statistical analysis was performed using paired t tests, Spearman’s rank correlation coefficients and ANCOVA.

Results: Mean age was 38 years (range 18–67) with 62% males and 38% females. The treatment resulted in significant improvements in all the recovery parameters (P < 0.005, paired t test). No significant association was detected between the BMI of subjects and % changes in pain intensity, self-experienced impairment and disability, and range of motion of the lumbar spine. A comparative analysis of the after treatment recovery parameter scores in normal (BMI ≤24.9), overweight (BMI 25–29.9) and obese (BMI ≥ 30) revealed no significant differences in the mean pain intensity and mean self-experienced impairment and disability scores.

Conclusion: Although a BMI within normal range is desirable for prevention of many health conditions including LBP, it does not influence the overall recovery from low back pain in patients undergoing physiotherapy treatment.