Bryan Cervical Disc Arthroplasty Versus Anterior Cervical Discectomy and Fusion for Treatment of Cervical Disc Diseases

Zhu, Yuhang; Tian, Zhishen; Zhu, Bitao; Zhang, Wenjing; Li, Youqiong; Zhu, Qingsan

doi:10.1097/brs.0000000000001367

Cited by 23 publications

(24 citation statements)

References 47 publications

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“…In all, five meta-analyses 32, 34, 35, 39, 41 and the short-term results of one meta-analysis 11 indicated that no significant difference existed between TDR and ACDF in improving the NDI score, although another five studies 7, 31, 38, 40, 42 and the long-term results of one study 11 showed that TDR was superior to ACDF, similar to the meta-analyses. The reasons for these findings may be as follows: (1) number of included studies differed significantly; (2) unfitted data was included in published meta-analysis; e.g., the data of Heller JG 2009 19 included the NDI improvement from baseline but not NDI score at the last follow-up; (3) some outcome data lacked SD values such as those of Mummaneni P 2007 in Xing D 2013 39 , which were excluded from the current study; and (4) comparison of Nabhan A 2011 in Xing D 2013 39 was between the ProDisc-C and ACDF using the Solis cage and a titanium plate, which was the only ACDF study included in the comparison.…”

Section: Discussionsupporting

confidence: 63%

“…In total, sixteen published meta-analyses 6, 7, 9, 10, 31–42 compared TDR using different replacements with ACDF. One published meta-analysis 11 was a comparison study between TDR using the Bryan disc and ACDF. The last search date of the seventeen studies was from March 2011 to October 2015.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas some results indicated that TDR was significantly superior to ACDF 6–8 regarding several clinical outcomes, other results showed no significant difference between the two treatments 9–11 . Additionally, the clinical effectiveness among TDR using different replacements and ACDF using different implants remain unresolved.…”

Section: Introductionmentioning

confidence: 94%

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Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease

Tian

et al. 2017

Sci Rep

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Anterior cervical discectomy and fusion (ACDF) and total cervical disc replacement (TDR) are considered effective treatments for patients with cervical degenerative disc disease (CDDD). An indirect meta-analysis including 19 randomized controlled trials (5343 patients) was conducted to compare the clinical outcomes of ACDF with TDR. Primary outcomes including functional indicators (NDI [neck disability index] score, neurological success and patient satisfaction), secondary outcomes including surgical outcomes (operation time, blood loss and length of stay) and secondary surgical procedures (secondary surgery at an adjacent level, secondary surgery at the index level, secondary surgery at both levels, removal, reoperation, revision and supplemental fixation) were included in the study. TDR using the Bryan disc was associated with a greater improvement in NDI score than ACDF (MD = −5.574, 95% CrIs [credible intervals] −11.73–−0.219). For neurological success, the Bryan (odds ratio [OR] = 0.559, 95% CrIs 0.323–0.955) and Prestige (OR = 0.474, 95% CrIs 0.319–0.700) discs were superior to ACDF. However, no differences in the patient satisfaction rate were shown between TDR and ACDF. For patients with CDDD, ACDF using allograft and a plate is most effective for determining the surgical parameters. Moreover, TDR using the ProDisc-C, Mobi-C, Prestige and Bryan discs are good choices for improving functional outcomes and reducing secondary surgeries.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

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Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease

Tian

et al. 2017

Sci Rep

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“…A meta-analysis by Zhu et al found no statistical difference in NDI scores when comparing those undergoing Bryan CDR to ACDF, but when looking further out they found favorable NDI scores in the CDR group. In the same study, range of motion was also better in the CDR group [44].…”

Section: Specific Implant Characteristics Bryan Artificial Discsupporting

confidence: 52%

Cervical disc replacement surgery: indications, technique, and technical pearls

Leven

Meaike

Radcliff

et al. 2017

Curr Rev Musculoskelet Med

100

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Purpose of review Cervical disc replacement (CDR) is a surgical option for appropriately indicated patients, and high success rates have been reported in the literature. Complications and failures are often associated with patient indications or technical variables, and the goal of this review is to assist surgeons in understanding these factors. Recent findings Several investigations have been published in the last 5 years supporting the use of CDR in specific patient populations. CDR has been shown to be comparable or favorable to anterior cervical discectomy and fusion in several meta-analyses and mid-term follow-up studies. Summary CDR was developed as a technique to preserve motion following a decompression procedure while minimizing several of the complications associated with fusion and posterior cervical spine procedures. Though success with cervical fusion and posterior foraminotomy has been well documented in the literature, high rates of mid-and long-term complications have been clearly established. CDR has also been associated with several complications and challenges with regard to surgical technique, though improvements in implant design have lead to an increase in utilization. Several devices currently exist and vary in terms of material, design, and outcomes. This review paper discusses indications, surgical technique, and technical pearls and reviews the CDR devices currently available.

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“…At 2-3 years, both CDA and ACDF groups showed equivalent NDI score improvement. At 4 years, however, the CDA group had improved NDI scores compared to those of the ACDF group (SMD = −0.37, P = .001) [17].…”

Section: Postoperative Activity Levelsmentioning

confidence: 99%

Cervical disc replacement surgery: biomechanical properties, postoperative motion, and postoperative activity levels

Pisano

Helgeson

2017

Curr Rev Musculoskelet Med

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Purpose of review Cervical disc arthroplasty (CDA) is an evolving technique used in the treatment of cervical disc disease. To remain up to date on studies regarding its efficacy, we sought to answer three questions: What do biomechanical studies demonstrate in regard to the kinematics of CDA? How does CDA affect cervical motion? What are the postoperative activity levels of patients after cervical disc arthroplasty? Recent findings 1) In regard to biomechanics, recent data suggests that CDA maintains motion while possibly altering facet biomechanics. 2) Radiographic data indicates a reliable maintenance of motion in the short and medium term. 3) Postoperative activity levels are assessed with clinical outcome data which demonstrate reliable improvement in pain and function.Summary The data reviewed here establishes CDA as an efficacious treatment in the relief of symptoms from CDD. It is important to note however that an evaluation of CDA would benefit from more robust data, specifically in regards to longterm clinical outcomes.

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Bryan Cervical Disc Arthroplasty Versus Anterior Cervical Discectomy and Fusion for Treatment of Cervical Disc Diseases

Abstract: 1.

Cited by 23 publications

References 47 publications

Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease

Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease

Cervical disc replacement surgery: indications, technique, and technical pearls

Cervical disc replacement surgery: biomechanical properties, postoperative motion, and postoperative activity levels

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