Symbol.Clinical outcome of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis: A midterm follow-up

BACKGROUND:

Although the short-term clinical efficacy of Bryan artificial cervical disc replacement is generally acknowledged by most spinal surgeons, the midterm and long term clinical results and complications are still unclear.

OBJECTIVE:

To summarize midterm term clinical results of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis.

METHOD:

From November 2004 to December 2007, 34 patients had Bryan cervical disc replacement in Department of Orthopedics, West China Hospital were selected, including 30 cases with single replacement and 4 cases with bi-level replacement. Clinical result was evaluated by SF-36 score, JOA score, and neck/arm pain VAS scores. And the data was collected before surgery and at 7 days, 3, 6, 12, 24, 36 and 48 months after surgery. Neutral lateral and dynamic cervical radiographs were made to measure the flexion-extension range of motion (ROM) of operative segment, adjacent segments and C_2-7 segment, the intervertebral height of operative and adjacent segments, and the translation of operative level. The intraoperative and postoperative complications were recorded and analyzed.

RESULTS AND CONCLUSION:

The neurological symptoms of each patient were alleviated notably. The postoperative SF-36 physical component score and SF-36 mental component score, JOA score, NDI score and neck/arm pain VAS scores were significantly improved compared with those of the preoperative (P < 0.05), but no statistical significance were noted between each time point after 3-month follow-up (P > 0.05). Each implanted prosthesis preserved the ROM>2° at each follow-up time point, and no heterotopic ossification or spontaneous fusion was found at the operative segment. At 48-month follow-up, flexion-extension ROM of operative segment and C_2-7 segment slightly increased but showed no statistical significance compared with the preoperative counterparts (P > 0.05); ROM of upper and lower adjacent segments also showed no statistical significance compared with the preoperative data (P > 0.05). Intervertebral height of operative segment was (6.04±1.02) mm before the operation and significantly increased to (8.44±0.43) mm at 48-month follow-up (P < 0.05). Intervertebral height of adjacent segments, and the translation of operative level were not significantly changed (P > 0.05). The clinical result of Bryan artificial cervical disc replacement is good and kinematic characteristics of operative segment, adjacent segments and C_2-7 segment can be maintained in midterm follow-up. The operation is safe and there are few early midterm complications.

Ding C, Liu H, Hu T, Shi R, Li T, Hong Y, Song YM, Liu LM, Zeng JC, Kong QQ. Clinical outcome of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis: A midterm follow-up.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2011;15(17): 3047-3052. [http://www.crter.cnhttp://en.zglckf.com]