Document Detail


Superiority of the Bryan(®) disc prosthesis for cervical myelopathy: a randomized study with 3-year followup.
MedLine Citation:
PMID:  21997779     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The current standard of care for cervical myopathy is anterior discectomy and fusion (ACDF). Although well tolerated in the short term, this treatment might ultimately result in progressive degeneration of adjacent motion segments. Artificial disc arthroplasty offers the theoretical advantage of preservation of motion at the operative level with consequent stress reduction at adjacent levels.
QUESTIONS/PURPOSES: We compared function, radiographic measures, and incidence of complications at 3-year followup after cervical disc arthroplasty with the Bryan(®) prosthesis and ACDF in patients with cervical myelopathy.
PATIENTS AND METHODS: Eighty-three patients with cervical myelopathy were randomized to undergo arthroplasty with implantation of a Bryan(®) cervical disc prosthesis (n = 41) or ACDF (n = 42). Patients were assessed preoperatively to 3 years postoperatively using the modified Odom's criteria, Japanese Orthopaedic Association scale, SF-36, and Neck Disability Index. ROM, stability, and subsidence of the prostheses were evaluated radiographically.
RESULTS: Patients who received the Bryan(®) prosthesis scored significantly better in three of the four functional assessment methods used (Japanese Orthopaedic Association scale, SF-36, and Neck Disability Index). ROM was retained by the patients in the Bryan(®) group but not in the patients in the ACDF group. Patients in the Bryan(®) group had fewer complications, primarily because dysphagia occurred in only one patient in the Bryan(®) group but in seven patients in the ACDF group. Other complications included pseudarthrosis in three patients in the ACDF group and one patient had spontaneous fusion, one had deep vein thrombosis, and one had heterotopic ossification in the Bryan(®) group.
CONCLUSIONS: Bryan(®) cervical disc arthroplasty appears reliable and effective in the treatment of cervical myelopathy.
LEVEL OF EVIDENCE: Level II, therapeutic study. See the Guidelines for Authors for a complete description of the levels of evidence.
Authors:
Lei Cheng; Lin Nie; Mu Li; Yong Huo; Xin Pan
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2011-10-14
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-08     Completed Date:  2012-08-17     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3408-14     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedics, Qilu Hospital, Shandong University, 107 West Wenhua Road, Jinan 250012, Shandong, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Loss, Surgical
Cervical Vertebrae*
Deglutition Disorders / etiology
Diskectomy*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Patient Selection
Prospective Studies
Prosthesis Design
Range of Motion, Articular
Sensitivity and Specificity
Spinal Cord Compression / physiopathology,  surgery*
Spinal Fusion
Total Disc Replacement*
Treatment Outcome
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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