Abstract
Background: Artificial cervical disc replacement has become an option for cervical radiculopathy. Previous studies have evaluated the efficacy of this alternative without the scientific rigor of a concurrent control population in oriental patients for long-term follow-up. Objective: Therefore, we asked whether the 1) clinical and 2) radiographic outcomes of Bryan cervical disc prosthesis were better than that of anterior cervical discectomy and fusion (ACDF) at single site, and whether the 3) occurrences of heterotopic ossifications (HOs) were associated to the function loss in the long-term follow-up. Methods: A total of 120 patients with cervical disc disease were randomly as- signed to two groups (Bryan or ACDF), and 60-month follow-up is available for all the 120 patients. Clinical outcomes were assessed using Odom's criteria, visual analogue pain scale (VAS) and Neck Disability Index (NDI). Radiographs were measured to determine the radiographic outcomes and occurrences of heterotopic ossifications (HOs). Results: The clinical outcomes are not significantly between the two groups (VAS, P = 0.7253; NDI, P = 0.5528). The radiographic outcome of Bryan cervical disc prosthesis is better than that of ACDF group at the index level (P < 0.05). 36 (60%) patients of Bryan group developed heterotopic ossification. But, there is not a significant associa- tion between HOs and the loss of movement at the replacement level. Conclusions: The Bryan ar- tificial disc replacement compares favorably to ACDF for the treatment of patients with 1-level cervical disc disease. And the Bryan disc may delay adjacent level degeneration by preserving preoperative kinematics at adjacent levels in oriental patients. * Co-first author. # Corresponding author.
Highlights
In recent years, much effort has been made to investigate the use of the artificial disc systems as an alternative to fusion
Several centers [3]-[6] have reported the use of the Bryan disc in the management of adjacent segment degeneration associated with previous fusion surgery and surgery at the cervicothoracic junction, and the short-term outcomes of Bryan disc replacement
The Bryan Cervical Disc prosthesis was available in our hospital since January 2004 and used with great enthusiasm in the hope that it could prevent adjacent segment disease, which was a well known late complication of anterior cervical discectomy and fusion (ACDF)
Summary
Much effort has been made to investigate the use of the artificial disc systems as an alternative to fusion It is well-documented that the immediate and short-term results of artificial disc arthroplasty are equivalent to those of ACDF [1] [2]. Several centers [3]-[6] have reported the use of the Bryan disc in the management of adjacent segment degeneration associated with previous fusion surgery and surgery at the cervicothoracic junction, and the short-term outcomes of Bryan disc replacement. Objective: we asked whether the 1) clinical and 2) radiographic outcomes of Bryan cervical disc prosthesis were better than that of anterior cervical discectomy and fusion (ACDF) at single site, and whether the 3) occurrences of heterotopic ossifications (HOs) were associated to the function loss in the long-term follow-up. The Bryan disc may delay adjacent level degeneration by preserving preoperative kinematics at adjacent levels in oriental patients
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