Advertisement

International Orthopaedics

, Volume 40, Issue 6, pp 1197–1203 | Cite as

Clinical and radiological analysis of Bryan cervical disc arthroplasty: eight-year follow-up results compared with anterior cervical discectomy and fusion

  • Tao Lei
  • Yaming Liu
  • Hui Wang
  • Jiaxin Xu
  • Qinghua Ma
  • Linfeng Wang
  • Yong ShenEmail author
Original Paper

Abstract

Purpose

Bryan cervical disc arthroplasty has been reported with satisfactory short- and medium-term clinical results. However, the long-term clinical and radiographic outcomes are seldom reported. The purpose of this study was to compare the eight-year follow-up results in patients who underwent Bryan disc arthroplasty with patients received ACDF, and assess the incidence of heterotopic ossification (HO) and its effect on clinical outcome and mobility of the device.

Methods

Thirty-one patients underwent Bryan disc arthroplasty, and 35 patients underwent ACDF were included in the study. The Japanese Orthopedic Association (JOA) scores, neck disability index (NDI), visual analogue scale (VAS) of neck and arm pain, and the radiographs were used to evaluate the outcomes. The heterotopic ossification (HO) was determined by CT scan and was classified into three subgroups to compare the related effect. Adjacent segment degeneration (ASD) was also observed.

Results

At final follow-up, there were no significant differences in JOA scores between two groups, but the improvement in NDI and neck or arm VAS were significantly greater in the Bryan disc cohort. The range of motion at the index level was 7.0° in Bryan group, while 100 % bone fusion were achieved in ACDF group. HO was observed in 18 (51.4 %) levels. There were more restricted movement of the prosthesis and slight higher rate of axial pain in patients with severe-HO (grade III and IV). Fourteen (28.6 %) levels developed ASD in Bryan group, which was significantly lower than that (58.6 %) in ACDF group.

Conclusions

At eight year follow-up, the clinical and radiographic outcomes of Bryan cervical disc arthroplasty compared favorably to those of ACDF. It avoided accelerated adjacent segment degeneration by preserving motion. However, severe HO restricted the ROM of the index levels and maybe associated with post-operative axial pain.

Keywords

Anterior cervical discectomy and fusion Bryan disc Cervical arthroplasty Clinical outcome Heterotopic ossification Movement 

Notes

Acknowledgments

The authors thank Dr. Lingde Kong for assistance with preparation of this manuscript.

Compliance with ethical standards

Conflict of interest

The authors have no funding or conflicts of interest to disclose.

References

  1. 1.
    Yang YC, Nie L, Cheng L, Hou Y (2009) Clinical and radiographic reports following cervical arthroplasty: a 24-month follow-up. Int Orthop 33(4):1037–1042CrossRefPubMedGoogle Scholar
  2. 2.
    Peng-Fei S, Yu-Hua J (2008) Cervical disc prosthesis replacement and interbody fusion: a comparative study. Int Orthop 32(1):103–106CrossRefPubMedGoogle Scholar
  3. 3.
    Anderson PA, Rouleau JP (2004) Intervertebral disc arthroplasty. Spine (Phila Pa 1976) 29(23):2779–2786CrossRefGoogle Scholar
  4. 4.
    Sasso RC, Smucker JD, Hacker RJ, Heller JG (2007) Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 Patients. Spine (Phila Pa 1976) 32(26):2933–2940, discussion 2941–2942CrossRefGoogle Scholar
  5. 5.
    Goffin J, Casey A, Kehr P, Liebig K, Lind B, Logroscino C, Pointillart V, Van Calenbergh F, van Loon J (2002) Preliminary clinical experience with the Bryan Cervical Disc Prosthesis. Neurosurgery 51(3):840–845, discussion 845–847PubMedGoogle Scholar
  6. 6.
    Zhang X, Zhang X, Chen C et al (2012) Randomized, controlled, multicenter, clinical trial comparing BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion in China. Spine (Phila Pa 1976) 37(6):433–438CrossRefGoogle Scholar
  7. 7.
    Ding C, Hong Y, Liu H, Shi R, Song Y, Li T (2013) Comparison of cervical disc arthroplasty with anterior cervical discectomy and fusion for the treatment of cervical spondylotic myelopathy. Acta Orthop Belg 79(3):338–346PubMedGoogle Scholar
  8. 8.
    Garrido BJ, Taha TA, Sasso RC (2010) Clinical outcomes of Bryan cervical disc arthroplasty a prospective, randomized, controlled, single site trial with48-month follow-up. J Spinal Disord Tech 23(6):367–371CrossRefPubMedGoogle Scholar
  9. 9.
    Muheremu A, Niu X, Wu Z, Muhanmode Y, Tian W (2015) Comparison of the short- and long-term treatment effect of cervical disk replacement and anterior cervical disk fusion: a meta-analysis. Eur J Orthop Surg Traumatol 25(Suppl 1):S87–S100CrossRefPubMedGoogle Scholar
  10. 10.
    Sasso RC, Anderson PA, Riew KD, Heller JG (2011) Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial. Orthopedics 34(11):889CrossRefPubMedGoogle Scholar
  11. 11.
    Goffin J, van Loon J, Van Calenbergh F, Lipscomb B (2010) A clinical analysis of 4- and 6-year follow-up results after cervical disc replacement surgery using the Bryan cervical disc prosthesis. J Neurosurg Spine 12(3):261–269CrossRefPubMedGoogle Scholar
  12. 12.
    Walraevens J, Demaerel P, Suetens P et al (2010) Longitudinal prospective long-term radiographic follow-up after treatment of single-level cervical disk disease with the Bryan Cervical Disc. Neurosurgery 67(3):679–687, discussion 687CrossRefPubMedGoogle Scholar
  13. 13.
    Kim SW, Limson MA, Kim SB et al (2009) Comparison of radiographic changes after anterior cervical diskectomy and fusion versus Bryan disc arthroplasty in single and bi-level case. Eur Spine J 18(2):218–231CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Sun Y, Zhao YB, Pan SF, Zhou FF, Chen ZQ, Liu ZJ (2012) Comparison of adjacent segment degeneration five years after singlelevel cervical fusion and cervical arthroplasty: a retrospective controlled study. Chin Med J (Engl) 125:3939–3941Google Scholar
  15. 15.
    White AA 3rd, Panjabi MM (1978) The basic kinematics of the human spine. A review of past and current knowledge. Spine (Phila Pa 1976) 3:12–20CrossRefGoogle Scholar
  16. 16.
    McAfee PC, Cunningham BW, Devine J, Williams E, Yu-Yahiro J (2003) Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech 16(4):384–389CrossRefPubMedGoogle Scholar
  17. 17.
    Heller JG, Sasso RC, Papadopoulos SM et al (2009) Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion. Spine (Phila Pa 1976) 34(2):101–107CrossRefGoogle Scholar
  18. 18.
    Quan GM, Vital JM, Hansen S, Pointillart V (2011) Eight-year clinical and radiological follow-up of the Bryan cervical disc arthroplasty. Spine (Phila Pa 1976) 36(8):639–646CrossRefGoogle Scholar
  19. 19.
    Jin YJ, Park SB, Kim MJ, Kim KJ, Kim HJ (2013) An analysis of heterotopic ossification in cervical disc arthroplasty: a novel morphologic classification of an ossified mass. Spine J 13(4):408–420CrossRefPubMedGoogle Scholar
  20. 20.
    Tu TH, Wu JC, Huang WC, Guo WY, Wu CL, Shih YH, Cheng H (2011) Heterotopic ossification after cervical total disc replacement: determination by CT and effects on clinical outcomes. J Neurosurg Spine 14(4):457–465CrossRefPubMedGoogle Scholar
  21. 21.
    Suchomel P, Jurák L, Benes V 3rd, Brabec R, Bradác O, Elgawhary S (2010) Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up. Eur Spine J 19(2):307–315CrossRefPubMedGoogle Scholar
  22. 22.
    Neal B (2003) Effects of heterotopic bone formation on outcome after hip arthroplasty. ANZ J Surg 73:422–426CrossRefPubMedGoogle Scholar
  23. 23.
    Rama KR, Vendittoli PA, Ganapathi M et al (2009) Heterotopic ossification after surface arthroplasty and total hip arthroplasty: a randomized study. J Arthroplasty 24:256–262CrossRefPubMedGoogle Scholar
  24. 24.
    Nabhan, Ishak B, Steudel WI, Ramadhan S, Steimer O (2011) Assessment of adjacent-segment mobility after cervical disc replacement versus fusion: RCT with 1 year’s results. Eur Spine J 20(6):934–941CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Eck JC, Humphreys SC, Lim TH et al (2002) Biomechanical study on the effect of cervical spine fusion on adjacent-leve intradiscal pressure and segmental motion. Spine (Phila Pa 1976) 27(22):2431–2434CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2016

Authors and Affiliations

  • Tao Lei
    • 1
  • Yaming Liu
    • 1
  • Hui Wang
    • 1
  • Jiaxin Xu
    • 1
  • Qinghua Ma
    • 1
  • Linfeng Wang
    • 1
  • Yong Shen
    • 1
    • 2
    Email author
  1. 1.From the Department of Spine Surgery, and The Key Laboratory of Orthopedic Biomechanics of Hebei ProvinceThe Third Hospital of Hebei Medical UniversityShijiazhuangChina
  2. 2.Department of Spine SurgeryThird Hospital of HeBei Medical UniversityShijiazhuangChina

Personalised recommendations