Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Spine Journal
Published in: European Spine Journal 12/2015

01-12-2015 | Review Article

Polyurethane on titanium unconstrained disc arthroplasty versus anterior discectomy and fusion for the treatment of cervical disc disease: a review of level I–II randomized clinical trials including clinical outcomes

Authors: María Aragonés, Eduardo Hevia, Carlos Barrios

Published in: European Spine Journal | Issue 12/2015

Login to get access

Abstract

Purpose

To contrast the clinical and radiologic outcomes and adverse events of anterior cervical discectomy and fusion (ACDF) with a single cervical disc arthroplasty design, the polyurethane on titanium unconstrained cervical disc (PTUCD).

Methods

This is a systematic review of randomized clinical trials (RCT) with evidence level I–II reporting clinical outcomes. After a search on different databases including PubMed, Cochrane Central Register of Controlled Trials, and Ovid MEDLINE, a total of 10 RCTs out of 51 studies found were entered in the study. RTCs were searched from the earliest available records in 2005 to November 2014.

Results

Out of a total of 1101 patients, 562 were randomly assigned into the PTUCD arthroplasty group and 539 into the ACDF group. The mean follow-up was 30.9 months. Patients undergoing arthroplasty had lower Neck Disability Index, and better SF-36 Physical component scores than ACDF patients. Patients with PTUCD arthroplasty had also less radiological degenerative changes at the upper adjacent level. Overall adverse events were twice more frequent in patients with ACDF. The rate of revision surgery including both adjacent and index level was slightly higher in patients with ACDF, showing no statistically significant difference.

Conclusions

According to this review, PTUCD arthroplasty showed a global superiority to ACDF in clinical outcomes. The impact of both surgical techniques on the cervical spine (radiological spine deterioration and/or complications) was more severe in patients undergoing ACDF. However, the rate of revision surgeries at any cervical level was equivalent for ACDF and PTUCD arthroplasty.
Literature
1.
Goffin J, Geusens E, Vantomme N et al (2004) Long-term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech 17:79–85CrossRefPubMed
2.
Yang YC, Nie L, Cheng L, Hou Y (2009) Clinical and radiographic reports following cervical arthroplasty: a 24-month follow-up. Int Orthop 33:1037–1042PubMedCentralCrossRefPubMed
3.
4.
Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 81:519–528PubMed
5.
Buchowski JM, Anderson PA, Sekhon L, Riew KD (2009) Cervical disc arthroplasty compared with arthrodesis for the treatment of myelopathy. Surgical technique. J Bone Joint Surg Am 91(Suppl. 2):223–232PubMed
6.
Steinmetz MP, Patel R, Traynelis V, Resnick DK, Anderson PA (2008) Cervical disc arthroplasty compared with fusion in a workers’ compensation population. Neurosurgery 63:741–747 (discussion 747) CrossRefPubMed
7.
Chen J, Wang X, Bai W, Shen X, Yuan W (2012) Prevalence of heterotopic ossification after cervical total disc arthroplasty: a meta-analysis. Eur Spine J 21:674–680PubMedCentralCrossRefPubMed
8.
Bartels RH, Donk R, Verbeek AL (2010) No justification for cervical disk prostheses in clinical practice: a meta-analysis of randomized controlled trials. Neurosurgery 66:1153–1160 (discussion 1160) CrossRefPubMed
9.
Rousseau MA, Cottin P, Levante S, Nogier A, Lazennec JY, Skalli W (2008) In vivo kinematics of two types of ball-and-socket cervical disc replacements in the sagittal plane: cranial versus caudal geometric center. Spine 33:E6–E9CrossRefPubMed
10.
Lazaro BC, Yucesoy K, Yuksel KZ, Kowalczyk I, Rabin D, Fink M, Duggal N (2010) Effect of arthroplasty design on cervical spine kinematics: analysis of the Bryan Disc, ProDisc-C, and Synergy disc. Neurosurg Focus 28:1–8CrossRef
11.
Park JJ, Quirno M, Cunningham MR et al (2010) Analysis of segmental cervical spine vertebral motion after prodisc-C cervical disc replacement. Spine 35:E285–E289CrossRefPubMed
12.
Kowalczyk I, Lazaro BC, Fink M, Rabin D, Duggal N (2011) Analysis of in vivo kinematics of 3 different cervical devices: Bryan disc, ProDisc-C, and Prestige LP disc. J Neurosurg Spine 15:630–635CrossRefPubMed
13.
Chen Y, Yuan W, Wu X et al (2013) The effect of range of motion after single-level discover cervical artificial disk replacement. J Spinal Disord Tech 26:E158–E162CrossRefPubMed
14.
Ryu WH, Kowalczyk I, Duggal N (2013) Long-term kinematic analysis of cervical spine after single-level implantation of Bryan cervical disc prosthesis. Spine J 13:628–634CrossRefPubMed
15.
Anderson PA, Sasso RC, Rouleau JP, Carlson CS, Goffin J (2004) The Bryan Cervical Disc: wear properties and early clinical results. Spine J 4:303S–309SCrossRefPubMed
16.
Papadopoulos S (2005) The Bryan cervical disc system. Neurosurg Clin North Am 16:629–636CrossRef
17.
18.
19.
Lefebvre C, Clarke MJ (2001) Identifying randomised trials. In: Egger M, Smith D, Altman DG (eds) Systematic reviews in healthcare, 2nd edn. BMJ Publishing Group, London
20.
Bhandari M, Busse JW, Jackowski D et al (2004) Association between industry funding and statistically significant pro-industry findings in medical and surgical randomized trials. CMAJ 170:477–480PubMedCentralPubMed
21.
Higgins JPT, Altman DG, Sterne JAC (2011) Assessing risk of bias in included studies. In: Higgins JPT, Green S (eds) Cochrane handbook for systematic reviews of interventions version 510 (updated March 2011). The Cochrane Collaboration
22.
Vernon H, Mior S (1991) The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther 14:409–415PubMed
23.
Carreon LY, Glassman SD, Campbell MJ, Anderson PA (2010) Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J 10:469–474CrossRefPubMed
24.
Hacker RJ (2005) Cervical disc arthroplasty: a controlled randomized prospective study with intermediate follow-up results. J Neurosurg Spine 3:424–428CrossRefPubMed
25.
Cheng L, Nie L, Zhang L, Hou Y (2009) Fusion versus Bryan Cervical Disc in two-level cervical disc disease: a prospective, randomised study. Int Orthop 33:1347–1351PubMedCentralCrossRefPubMed
26.
Riew KD, Buchowski JM, Sasso R et al (2008) Cervical disc arthroplasty compared with arthrodesis for the treatment of myelopathy. J Bone Joint Surg Am 90:2354–2364CrossRefPubMed
27.
Kim SW, Limson MA, Kim SB et al (2009) Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J 18:218–231PubMedCentralCrossRefPubMed
28.
Garrido BJ, Taha TA, Sasso RC (2010) Clinical outcomes of Bryan cervical disc arthroplasty a prospective, randomized, controlled, single site trial with 48-month follow-up. J Spinal Disord Tech 23:367–371CrossRefPubMed
29.
Coric D, Cassis J, Carew JD, Boltes MO (2010) Prospective study of cervical arthroplasty in 98 patients involved in 1 of 3 separate investigational device exemption studies from a single investigational site with a minimum 2-year follow-up: clinical article. J Neurosurg Spine 13:715–721CrossRefPubMed
30.
Cheng L, Nie L, Li M, Huo Y, Pan X (2011) Superiority of the BRYAN(®) disc prosthesis for cervical myelopathy: a randomized study with 3-year follow-up. Clin Orthop Relat Res 469:3408–3414PubMedCentralCrossRefPubMed
31.
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. J Bone Joint Surg Am 93:1684–1692CrossRefPubMed
32.
Sun Y, Zhao YB, Pan SF, Zhou FF et al (2012) Comparison of adjacent segment degeneration five years after single level cervical fusion and cervical arthroplasty: a retrospective controlled study. Chin Med J 125:3939–3941PubMed
33.
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 37:433–438CrossRefPubMed
34.
Young IA, Cleland JA, Michener LA, Brown C (2010) Reliability, construct validity, and responsiveness of the neck disability index, patient-specific functional scale, and numeric pain rating scale in patients with cervical radiculopathy. Am J Phys Med Rehabil 89:831–839CrossRefPubMed
35.
Alvin MD, Abbott E, Lubelski D et al (2014) Cervical arthroplasty: a critical review of the literature. Spine J 14:2231–2245CrossRefPubMed
36.
Yin S, Yu X, Zhou S, Yin Z, Qiu Y (2013) Is cervical disc arthroplasty superior to fusion for treatment of symptomatic cervical disc disease? A meta-analysis. Clin Orthop Relat Res 471:1904–1919PubMedCentralCrossRefPubMed
37.
McAfee PC, Reah C, Gilder K, Eisermann L, Cunningham B (2012) A meta-analysis of comparative outcomes following cervical arthroplasty or anterior cervical fusion: results from 4 prospective multicenter randomized clinical trials and up to 1226 patients. Spine 37:943–952CrossRefPubMed
38.
Eck JC, Humphreys SC, Lim TH et al (2002) Biomechanical study on the effect of cervical spine fusion on adjacent-level intradiscal pressure and segmental motion. Spine 27:2431–2434CrossRefPubMed
39.
Ruetten S, Komp M, Merk H, Godolias G (2009) Full-endoscopic anterior decompression versus conventional anterior decompression and fusion in cervical disc herniations. Int Orthop 33:1677–1682PubMedCentralCrossRefPubMed
40.
Liao JC, Niu CC, Chen WJ, Chen LH (2008) Polyetheretherketone (PEEK) cage filled with cancellous allograft in anterior cervical discectomy and fusion. Int Orthop 32:643–648PubMedCentralCrossRefPubMed
41.
Heller JG, Sasso RC, Papadopoulos SM et al (2009) Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial. Spine 34:101–107CrossRefPubMed
42.
Anderson PA, Sasso RC, Riew KD (2008) Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis. Spine 33:1305–1312CrossRefPubMed
43.
Gao Y, Liu M, Li T, Huang F, Tang T, Xiang Z (2013) A meta-analysis comparing the results of cervical disc arthroplasty with anterior cervical discectomy and fusion (ACDF) for the treatment of symptomatic cervical disc disease. J Bone Joint Surg Am 95:555–561PubMedCentralCrossRefPubMed
44.
Yi S, Shin DA, Kim KN (2013) The predisposing factors for the heterotopic ossification after cervical artificial disc replacement. Spine J 13:1048–1054CrossRefPubMed
45.
Yi S, Kim KN, Yang MS (2010) Difference in occurrence of heterotopic ossification according to prosthesis type in the cervical artificial disc replacement. Spine 35:1556–1561CrossRefPubMed
46.
Pickett GE, Sekhon LH, Sears WR, Duggal N (2006) Complications with cervical arthroplasty. J Neurosurg Spine 4:98–105CrossRefPubMed
47.
Baron EM, Soliman AM, Gaughan JP et al (2003) Dysphagia, hoarseness, and unilateral true vocal fold motion impairment following anterior cervical diskectomy and fusion. Ann Otol Rhinol Laryngol 112:921–926CrossRefPubMed
48.
49.
Ruetten S, Komp M, Merk H, Godolias G (2008) Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine 33:940–948CrossRefPubMed
Metadata
Title
Polyurethane on titanium unconstrained disc arthroplasty versus anterior discectomy and fusion for the treatment of cervical disc disease: a review of level I–II randomized clinical trials including clinical outcomes
Authors
María Aragonés
Eduardo Hevia
Carlos Barrios
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 12/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4228-z

Other articles of this Issue 12/2015

European Spine Journal 12/2015 Go to the issue

Grand Rounds

Expert’s comment concerning Grand Rounds case entitled “Surgical challenges in the management of cervical kyphotic deformity in patients with severe osteoporosis: an illustrative case of a patient with Hajdu-Cheney syndrome” (T. A. Mattei, A. A. Rehman, A. Issawi, D. R. Fassett)

Ideas and Technical Innovations

How old is your cervical spine? Cervical spine biological age: a new evaluation scale

Original Article

Relationship between modic changes and facet joint degeneration in the cervical spine

Original Article

Does lumbar spinal stenosis increase the risk of spondylotic cervical spinal cord compression?

Original Article

Influence of cervical bone mineral density on cage subsidence in patients following stand-alone anterior cervical discectomy and fusion

Original Article

Functional computed tomography scanning for evaluating fusion status after anterior cervical decompression fusion