Better Outcomes for Cervical Spine Arthroplasty Than Fusion

Significant, persistently better outcomes from cervical spine arthroplasty than cervical fusion

FRIDAY, Sept. 30 (HealthDay News) -- For treatment of single-level degenerative cervical disc disease, the use of cervical disc arthroplasty is associated with significantly superior outcomes at 48 months versus anterior cervical discectomy with fusion, according to a study published in the Sept. 21 issue of The Journal of Bone & Joint Surgery.

Rick C. Sasso, M.D., from the Indiana Spine Group in Indianapolis, and colleagues assessed the use of the Bryan disc as an alternative to arthrodesis after anterior cervical discectomy. A total of 181 and 138 patients received the Bryan disc (arthroplasty group) or underwent anterior cervical discectomy and fusion (fusion group), respectively. Preoperative and postoperative self-assessment forms were completed at specified intervals, and radiographs were performed preoperatively at six weeks, and at three, six, 12, 24, and 48 months after surgery.

The investigators identified substantial reduction in neck disability index scores in both groups, with significantly greater improvement in the arthroplasty group through the four-year follow-up period. The four-year overall success rates were found to be 85.1 and 72.5 percent for the arthroplasty and fusion groups, respectively. Significantly greater improvement was observed in the arm and neck pain scores and short form-36 physical component score in the arthroplasty group at 48-months follow-up, though both groups had substantial improvement in arm pain scores. At 24 and 48 months, the mean range of motion for the arthroplasty group was 8.08 and 8.48 degrees, respectively. Total and serious adverse event rates were similar for the two groups.

"The 48-month follow-up data in the present report showed consistent, sustained significantly superior outcomes for cervical spine arthroplasty compared with cervical spine fusion," the authors write.

One or more of the study authors disclosed financial relationships with biomedical companies, including Medtronic, the manufacturer of the Bryan Cervical Disc.

Full Text (subscription or payment may be required)

Physician's Briefing