Comparison of Clinical and Radiographic Changes after Bryan Disc Arthroplasty versus ACDF: A 60-Month Follow-Up on 120 Patients
Affiliation(s)
1 Department of Orthopaedic Surgery, General Hospital of Tianjin Medical University, Tianjin, China. 2 Department of Orthopaedic Surgery, Tianjin TEDA Hospital, Tianjin, China.
1 Department of Orthopaedic Surgery, General Hospital of Tianjin Medical University, Tianjin, China. 2 Department of Orthopaedic Surgery, Tianjin TEDA Hospital, Tianjin, China.
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 assigned 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 ofBryancervical disc prosthesis is better than that of ACDF group at the index level (P < 0.05). 36 (60%) patients ofBryangroup developed heterotopic ossification. But, there is not a significant association between HOs and the loss of movement at the replacement level. Conclusions: The Bryan artificial disc replacement compares favorably to ACDF for the treatment of patients with 1-level cervical disc disease. And theBryandisc may delay adjacent level degeneration by preserving preoperative kinematics at adjacent levels in oriental patients.
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 assigned 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 ofBryancervical disc prosthesis is better than that of ACDF group at the index level (P < 0.05). 36 (60%) patients ofBryangroup developed heterotopic ossification. But, there is not a significant association between HOs and the loss of movement at the replacement level. Conclusions: The Bryan artificial disc replacement compares favorably to ACDF for the treatment of patients with 1-level cervical disc disease. And theBryandisc may delay adjacent level degeneration by preserving preoperative kinematics at adjacent levels in oriental patients.
Cite this paper
Cao, F. , Liu, T. , Xu, Y. , Han, H. , Dong, R. and Feng, S. (2015) Comparison of Clinical and Radiographic Changes after Bryan Disc Arthroplasty versus ACDF: A 60-Month Follow-Up on 120 Patients. World Journal of Neuroscience, 5, 40-48. doi: 10.4236/wjns.2015.51005.
Cao, F. , Liu, T. , Xu, Y. , Han, H. , Dong, R. and Feng, S. (2015) Comparison of Clinical and Radiographic Changes after Bryan Disc Arthroplasty versus ACDF: A 60-Month Follow-Up on 120 Patients. World Journal of Neuroscience, 5, 40-48. doi: 10.4236/wjns.2015.51005.
References
[1] Grob, D., Porchet, F., Kleinstück, F.S., Lattig, F. and Jeszenszky, D. (2010) A Comparison of Outcomes of Cervical Disc Arthroplasty and Fusion in Everyday Clinical Practice: Surgical and Methodological Aspects. European Spine Journal, 19, 297-306. http://dx.doi.org/10.1007/s00586-009-1194-3 [2] Garrido, B.J., Taha, T.A. and Sasso, R.C. (2010) Clinical Outcomes of Bryan Cervical Disc Arthroplasty—A Prospective, Randomized, Controlled, Single Site Trial with 48-Month Follow-Up. Journal of Spinal Disorders Techniques, 23, 367-371. http://dx.doi.org/10.1097/BSD.0b013e3181bb8568 [3] Vernon, H. and Mior, S. (1991) The Neck Disability Index: A Study of Reliability and Validity. Journal of Manipulative and Physiological Therapeutics, 14, 409-415. [4] McAfee, P.C., Cunningham, B.W., Devine, J., Williams, E., Yu-Yahiro, J., et al. (2003) Classification of Heterotopic Ossification (HO) in Artificial Disk Replacement. Journal of Spinal Disorders Techniques, 16, 384-389. http://dx.doi.org/10.1097/00024720-200308000-00010 [5] Ahn, P.G., Kim, K.N., Moon, S.W. and Kim, K.S. (2009) Changes in Cervical Range of Motion and Sagittal Alignment in Early and Late Phases after Total Disc Replacement: Radiographic Follow-Up Exceeding 2 Years. Journal of Neurosurgery: Spine, 11, 688-695. http://dx.doi.org/10.3171/2009.7.SPINE0946 [6] Shim, C.S., Lee, S.H., Park, H.J., Kang, H.S. and Hwang, J.H. (2006) Early Clinical and Radiologic Outcomes of Cervical Arthroplasty with Bryan Cervical Disc Prosthesis. Journal of Spinal Disorders Techniques, 19, 465-470. http://dx.doi.org/10.1097/01.bsd.0000211235.76093.6b [7] Leung, C., Casey, A.T., Goffin, J., Kehr, P. and Liebig, K. (2005) Clinical Significance of Heterotopic Ossification in Cervical Disc Replacement: A Prospective Multicenter Clinical Trial. Neurosurgery, 57, 759-763. http://dx.doi.org/10.1227/01.NEU.0000175856.31210.58 [8] Garrido, B.J., Taha, T.A. and Sasso, R.C. (2010) Clinical Outcomes of Bryan Cervical Disc Arthroplasty a Prospective, Randomized, Controlled, Single Site Trial with 48-Month Follow-Up. Journal of Spinal Disorders Techniques, 23, 367-371. http://dx.doi.org/10.1097/BSD.0b013e3181bb8568 [9] Singh, K., Phillips, F.M., Park, D.K., Pelton, M.A., An, H.S. and Goldberg, E.J. (2012) Factors Affecting Reoperations after Anterior Cervical Discectomy and Fusion within and outside of a Federal Drug Administration Investigational Device Exemption Cervical Disc Replacement Trial. Spine Journal, 12, 372-378. http://dx.doi.org/10.1016/j.spinee.2012.02.005 [10] Powell, J.W., Sasso, R.C., Metcalf, N.H., Anderson, P.A. and Hipp, J.A. (2010) Quality of Spinal Motion with Cervical Disk Arthroplasty Computer-Aided Radiographic Analysis. Journal of Spinal Disorders Techniques, 23, 89-95. http://dx.doi.org/10.1097/BSD.0b013e3181991413 [11] Kang, K.C., Lee, C.S., Han, J.H. and Chung, S.S. (2010) The Factors That Influence the Postoperative Segmental Range of Motion after Cervical Artificial Disc Replacement. The Spine Journal, 10, 689-696. http://dx.doi.org/10.1016/j.spinee.2010.04.016 [12] Heller, J.G., Sasso, R.C., Papadopoulos, S.M., Anderson, P.A. and Fessler, R.G. (2009) Comparison of BRYAN Cervical Disc Arthroplasty with Anterior Cervical Decompression and Fusion: Clinical and Radiographic Results of a Randomized, Controlled, Clinical Trial. Spine, 34, 101-107.
http://dx.doi.org/10.1097/BRS.0b013e31818ee263 [13] Kim, S.W., Limson, M.A., Kim, S.B., Arbatin, J.J. and Chang, K.Y. (2009) Comparison of Radiographic Changes after ACDF versus Bryan Disc Arthroplasty in Single and Bi-Level Cases. European Spine Journal, 18, 218-231. http://dx.doi.org/10.1007/s00586-008-0854-z [14] Sasso, R.C., Best, N.M., Metcalf, N.H. and Anderson, P.A. (2008) Motion Analysis of Bryan Cervical Disc Arthroplasty versus Anterior Discectomy and Fusion: Results from a Prospective, Randomized, Multicenter, Clinical Trial. Journal of Spinal Disorders Techniques, 21, 393-399.
http://dx.doi.org/10.1097/BSD.0b013e318150d121
[1] Grob, D., Porchet, F., Kleinstück, F.S., Lattig, F. and Jeszenszky, D. (2010) A Comparison of Outcomes of Cervical Disc Arthroplasty and Fusion in Everyday Clinical Practice: Surgical and Methodological Aspects. European Spine Journal, 19, 297-306. http://dx.doi.org/10.1007/s00586-009-1194-3 [2] Garrido, B.J., Taha, T.A. and Sasso, R.C. (2010) Clinical Outcomes of Bryan Cervical Disc Arthroplasty—A Prospective, Randomized, Controlled, Single Site Trial with 48-Month Follow-Up. Journal of Spinal Disorders Techniques, 23, 367-371. http://dx.doi.org/10.1097/BSD.0b013e3181bb8568 [3] Vernon, H. and Mior, S. (1991) The Neck Disability Index: A Study of Reliability and Validity. Journal of Manipulative and Physiological Therapeutics, 14, 409-415. [4] McAfee, P.C., Cunningham, B.W., Devine, J., Williams, E., Yu-Yahiro, J., et al. (2003) Classification of Heterotopic Ossification (HO) in Artificial Disk Replacement. Journal of Spinal Disorders Techniques, 16, 384-389. http://dx.doi.org/10.1097/00024720-200308000-00010 [5] Ahn, P.G., Kim, K.N., Moon, S.W. and Kim, K.S. (2009) Changes in Cervical Range of Motion and Sagittal Alignment in Early and Late Phases after Total Disc Replacement: Radiographic Follow-Up Exceeding 2 Years. Journal of Neurosurgery: Spine, 11, 688-695. http://dx.doi.org/10.3171/2009.7.SPINE0946 [6] Shim, C.S., Lee, S.H., Park, H.J., Kang, H.S. and Hwang, J.H. (2006) Early Clinical and Radiologic Outcomes of Cervical Arthroplasty with Bryan Cervical Disc Prosthesis. Journal of Spinal Disorders Techniques, 19, 465-470. http://dx.doi.org/10.1097/01.bsd.0000211235.76093.6b [7] Leung, C., Casey, A.T., Goffin, J., Kehr, P. and Liebig, K. (2005) Clinical Significance of Heterotopic Ossification in Cervical Disc Replacement: A Prospective Multicenter Clinical Trial. Neurosurgery, 57, 759-763. http://dx.doi.org/10.1227/01.NEU.0000175856.31210.58 [8] Garrido, B.J., Taha, T.A. and Sasso, R.C. (2010) Clinical Outcomes of Bryan Cervical Disc Arthroplasty a Prospective, Randomized, Controlled, Single Site Trial with 48-Month Follow-Up. Journal of Spinal Disorders Techniques, 23, 367-371. http://dx.doi.org/10.1097/BSD.0b013e3181bb8568 [9] Singh, K., Phillips, F.M., Park, D.K., Pelton, M.A., An, H.S. and Goldberg, E.J. (2012) Factors Affecting Reoperations after Anterior Cervical Discectomy and Fusion within and outside of a Federal Drug Administration Investigational Device Exemption Cervical Disc Replacement Trial. Spine Journal, 12, 372-378. http://dx.doi.org/10.1016/j.spinee.2012.02.005 [10] Powell, J.W., Sasso, R.C., Metcalf, N.H., Anderson, P.A. and Hipp, J.A. (2010) Quality of Spinal Motion with Cervical Disk Arthroplasty Computer-Aided Radiographic Analysis. Journal of Spinal Disorders Techniques, 23, 89-95. http://dx.doi.org/10.1097/BSD.0b013e3181991413 [11] Kang, K.C., Lee, C.S., Han, J.H. and Chung, S.S. (2010) The Factors That Influence the Postoperative Segmental Range of Motion after Cervical Artificial Disc Replacement. The Spine Journal, 10, 689-696. http://dx.doi.org/10.1016/j.spinee.2010.04.016 [12] Heller, J.G., Sasso, R.C., Papadopoulos, S.M., Anderson, P.A. and Fessler, R.G. (2009) Comparison of BRYAN Cervical Disc Arthroplasty with Anterior Cervical Decompression and Fusion: Clinical and Radiographic Results of a Randomized, Controlled, Clinical Trial. Spine, 34, 101-107.
http://dx.doi.org/10.1097/BRS.0b013e31818ee263 [13] Kim, S.W., Limson, M.A., Kim, S.B., Arbatin, J.J. and Chang, K.Y. (2009) Comparison of Radiographic Changes after ACDF versus Bryan Disc Arthroplasty in Single and Bi-Level Cases. European Spine Journal, 18, 218-231. http://dx.doi.org/10.1007/s00586-008-0854-z [14] Sasso, R.C., Best, N.M., Metcalf, N.H. and Anderson, P.A. (2008) Motion Analysis of Bryan Cervical Disc Arthroplasty versus Anterior Discectomy and Fusion: Results from a Prospective, Randomized, Multicenter, Clinical Trial. Journal of Spinal Disorders Techniques, 21, 393-399.
http://dx.doi.org/10.1097/BSD.0b013e318150d121