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Fusion versus Bryan Cervical Disc in two-level cervical disc disease: a prospective, randomised study

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Abstract

In this prospective study, our aim was to compare the functional results and radiographic outcomes of fusion and Bryan Cervical Disc replacement in the treatment of two-level cervical disc disease. A total of 65 patients with two-level cervical disc disease were randomly assigned to two groups, those operated on with Bryan Cervical Disc replacement (31) and those operated on with anterior cervical fusion with an iliac crest autograft and plate (34). Clinical evaluation was carried out using the visual analogue scale (VAS), the Short Form 36 (SF-36) and the neck disability index (NDI) during a two year follow-up. Radiological evaluation sought evidence of range of motion, stability and subsidence of the prosthesis. Substantial reduction in NDI scores occurred in both groups, with greater percent improvement in the Bryan group (P = 0.023). The arm pain VAS score improvement was substantial in both groups. Bryan artificial cervical disc replacement seems reliable and safe in the treatment of patients with two-level cervical disc disease.

Résumé

Cette étude prospective a pour but de comparer les résultats fonctionnels et radiographiques des patients ayant bénéficié soit d’une fusion, soit d’une athrodèse, soit d’une prothèse discale dans le traitement des lésions dégénératives des disques cervicaux portant sur deux niveaux. 65 patients présentant de telles lésions ont été randomisés en deux groupes, ceux traités par la prothèse discale de Bryan (31) et ceux traités par ostéosynthèse antérieure avec autogreffe illiaque et plaque (34). L’évaluation clinique a été réalisée en utilisant le score douleur VAS, (échelle analogique), le score SF-36, la raideur de la nuque index NDI, après deux ans de recul. L’évaluation radiologique permet de mettre en évidence les secteurs de mobilité de stabilité et la migration de la prothèse. Une diminution significative du score NDI est observée dans les deux groupes avec un pourcentage plus important d’amélioration dans le groupe des prothèses de type Bryan (p = 0.023). Le score douleur est nettement amélioré dans les deux groupes néanmoins il semble que la prothèse de type Bryan permet d’avoir des résultats beaucoup plus fiables et beaucoup plus sûrs dans le traitement de ces patients présentant des lésions discales dégénératives cervicales sur deux niveaux.

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Correspondence to Lei Cheng.

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Cheng, L., Nie, L., Zhang, L. et al. Fusion versus Bryan Cervical Disc in two-level cervical disc disease: a prospective, randomised study. International Orthopaedics (SICOT) 33, 1347–1351 (2009). https://doi.org/10.1007/s00264-008-0655-3

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  • DOI: https://doi.org/10.1007/s00264-008-0655-3

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