European Spine Journal

, Volume 23, Issue 3, pp 627–634 | Cite as

Differences between arthroplasty and anterior cervical fusion in two-level cervical degenerative disc disease

  • Li-Yu Fay
  • Wen-Cheng Huang
  • Tzu-Yun Tsai
  • Jau-Ching WuEmail author
  • Chin-Chu Ko
  • Tsung-Hsi Tu
  • Ching-Lan Wu
  • Henrich Cheng
Original Article



Although arthroplasty is an accepted option for two-level disease, there is a paucity of data regarding outcomes of two-level cervical arthroplasty. The current study was designed to determine differences between two-level cervical arthroplasty and anterior fusion.


Seventy-seven consecutive patients who underwent two-level anterior cervical operations for degenerative disc disease were divided into the arthroplasty (37 patients) and fusion (40 patients) groups. Clinical outcomes were measured by Visual Analogue Scale (VAS) of neck and arm pain, Japanese Orthopedic Association (JOA) scores, and Neck Disability Index (NDI). Every patient was evaluated by radiography and computed tomography for fusion or detection of heterotopic ossification.


Thirty-seven patients (with 74 levels of Bryan discs) were compared with 40 patients who had two-level anterior fusion (mean follow-up of 39.6 ± 6.7 months). There was no difference in sex, but the mean age of the arthroplasty group was significantly younger (52.1 ± 9.1 vs. 63.0 ± 10.6 years, p < 0.001). The mean estimated blood loss was similar (p = 0.135), but the mean operation time was longer in the arthroplasty group (315.5 ± 82.0 versus 224.9 ± 61.8 min, p < 0.001). At 24 months post-operation, the arthroplasty group had increased their range of motion than pre-operation (23.5° versus 20.1°, p = 0.018). There were significant improvements in neck or arm VAS, JOA scores, and NDI in both groups. However, there were no differences in clinical outcomes or adverse events between the two groups.


Clinical outcomes of two-level arthroplasty and anterior cervical fusion are similar 39.6 months after surgery. Cervical arthroplasty preserves mobility at the index levels without increased adverse effects.


Bryan disc Cervical arthroplasty Degenerative disc disease (DDD) Heterotopic ossification Anterior cervical discectomy and fusion (ACDF) 



No funds were received in support of this work and no benefits in any form have been and will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study, or the findings specified in this paper.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Li-Yu Fay
    • 1
    • 2
    • 3
  • Wen-Cheng Huang
    • 1
    • 2
  • Tzu-Yun Tsai
    • 4
    • 5
  • Jau-Ching Wu
    • 1
    • 2
    • 3
    Email author
  • Chin-Chu Ko
    • 1
    • 2
    • 3
  • Tsung-Hsi Tu
    • 1
    • 2
    • 7
  • Ching-Lan Wu
    • 2
    • 6
  • Henrich Cheng
    • 1
    • 2
    • 3
  1. 1.Department of Neurosurgery, Neurological InstituteTaipei Veterans General HospitalTaipeiTaiwan
  2. 2.School of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  3. 3.Institute of PharmacologyNational Yang-Ming UniversityTaipeiTaiwan
  4. 4.Department of Ophthalmology, National Taiwan University Hospital, College of MedicineNational Taiwan UniversityTaipeiTaiwan
  5. 5.Department of OphthalmologyNew Taipei City HospitalTaipeiTaiwan
  6. 6.Department of RadiologyTaipei Veterans General HospitalTaipeiTaiwan
  7. 7.Molecular Medicine Program, Taiwan International Graduate Program (TIGP)Academia SinicaTaipeiTaiwan

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