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Cervical disc replacement — emerging equivalency to anterior cervical discectomy and fusion

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Abstract

Purpose

Cervical disc replacement has become an acceptable alternative to anterior cervical fusion for the surgical treatment of cervical spine spondylosis resulting in radiculopathy or myelopathy following anterior discectomy and decompression. This concise overview considers the current state of knowledge regarding the continued debate of the role of cervical disc replacement with an update in light of the latest clinical trial results.

Methods

A literature review was performed identifying clinical trials pertaining to the use of cervical disc replacement compared to cervical discectomy and fusion. Single level disease and two level disease were considered. Outcome data from the major clinical trials was reviewed and salient points identified.

Results

With lengthier follow-up data becoming available, the equivalence of CDR in appropriately selected cases is becoming clear. This is chiefly manifested by reduced re-operation rates and reduced incidence of adjacent level disease in those treated with arthroplasty.

Conclusion

Cervical disc replacement shows emerging equivalence in outcomes compared to the gold standard anterior cervical discectomy and fusion. Further longer term results are anticipated to confirm this trend.

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References

  1. Fernstrom U (1966) Arthroplasty with intercorporal endoprothesis in herniated disc and in painful disc. Acta Chir Scand Suppl 357:154–159

    CAS  PubMed  Google Scholar 

  2. Cavanaugh DA, Nunley PD, Kerr EJ 3rd, Werner DJ, Jawahar A (2009) Delayed hyper-reactivity to metal ions after cervical disc arthroplasty: a case report and literature review. Spine (Phila Pa 1976) 34:E262–E265

    Article  Google Scholar 

  3. Anderson PA, Rouleau JP, Toth JM, Riew KD (2004) A comparison of simulator-tested and -retrieved cervical disc prostheses. Invited submission from the joint section meeting on disorders of the spine and peripheral nerves, March 2004. J Neurosurg Spine 1:202–210

    Article  PubMed  Google Scholar 

  4. Kurtz SM, Toth JM, Siskey R et al (2012) The latest lessons learned from retrieval analyses of ultra-high molecular weight polyethylene, metal-on-metal, and alternative bearing total disc replacements. Semin Spine Surg 24:57–70

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lebl DR, Cammisa FP Jr, Girardi FP, Wright T, Abjornson C (2012) The mechanical performance of cervical total disc replacements in vivo: prospective retrieval analysis of prodisc-C devices. Spine (Phila Pa 1976) 37:2151–2160

    Article  Google Scholar 

  6. Veruva SY, Steinbeck MJ, Toth J, Alexander DD, Kurtz SM (2014) Which design and biomaterial factors affect clinical wear performance of total disc replacements? A systematic review. Clin Orthop Relat Res 472:3759–3769

    Article  PubMed  PubMed Central  Google Scholar 

  7. Burkus JK, Traynelis VC, Haid RW Jr, Mummaneni PV (2014) Clinical and radiographic analysis of an artificial cervical disc: 7-year follow-up from the prestige prospective randomized controlled clinical trial: clinical article. J Neurosurg Spine 21:516–528

    Article  PubMed  Google Scholar 

  8. Hisey MS, Bae HW, Davis RJ et al (2015) Prospective, randomized comparison of cervical total disk replacement versus anterior cervical fusion: results at 48 months follow-up. J Spinal Disord Tech 28:E237–E243

    Article  PubMed  Google Scholar 

  9. Janssen ME, Zigler JE, Spivak JM et al (2015) ProDisc-C total disc replacement versus anterior cervical discectomy and fusion for single-level symptomatic cervical disc disease: seven-year follow-up of the prospective randomized U.S Food and Drug Administration Investigational Device Exemption Study. J Bone Joint Surg Am 97:1738–1747

    Article  PubMed  Google Scholar 

  10. Phillips FM, Geisler FH, Gilder KM et al (2015) Long-term outcomes of the US FDA IDE prospective randomized controlled clinical trial comparing PCM cervical disc arthroplasty with anterior cervical discectomy and fusion. Spine (Phila Pa 1976) 40:674–683

    Article  Google Scholar 

  11. 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 93:1684–1692

    Article  PubMed  Google Scholar 

  12. Burkus JK, Haid RW, Traynelis VC, Mummaneni PV (2010) Long-term clinical and radiographic outcomes of cervical disc replacement with the prestige disc: results from a prospective randomized controlled clinical trial. J Neurosurg Spine 13:308–318

    Article  PubMed  Google Scholar 

  13. Phillips FM, Lee JY, Geisler FH et al (2013) A prospective, randomized, controlled clinical investigation comparing PCM cervical disc arthroplasty with anterior cervical discectomy and fusion. 2-year results from the US FDA IDE clinical trial. Spine (Phila Pa 1976) 38:E907–E918

    Article  Google Scholar 

  14. Sasso RC, Smucker JD, Hacker RJ, Heller JG (2007) Clinical outcomes of BRYAN cervical disc arthroplasty: a prospective, randomized, controlled, multicenter trial with 24-month follow-up. J Spinal Disord Tech 20:481–491

    Article  PubMed  Google Scholar 

  15. Zigler JE, Delamarter R, Murrey D, Spivak J, Janssen M (2013) ProDisc-C and anterior cervical discectomy and fusion as surgical treatment for single-level cervical symptomatic degenerative disc disease: five-year results of a Food and Drug Administration study. Spine (Phila Pa 1976) 38:203–209

    Article  Google Scholar 

  16. 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 10:469–474

    Article  PubMed  Google Scholar 

  17. Shea BJ, Grimshaw JM, Wells GA et al (2007) Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol 7:10

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tashani OA, El-Tumi H, Aneiba K (2015) Quality of systematic reviews: an example of studies comparing artificial disc replacement with fusion in the cervical spine. Libyan J Med 10:28857

    Article  PubMed  Google Scholar 

  19. Boselie TF, Willems PC, van Mameren H et al (2012) Arthroplasty versus fusion in single-level cervical degenerative disc disease. Cochrane Database Syst Rev 9:CD009173

    PubMed  Google Scholar 

  20. Boselie TF, Willems PC, van Mameren H et al (2015) WITHDRAWN: arthroplasty versus fusion in single-level cervical degenerative disc disease. Cochrane Database Syst Rev 5:CD009173

    PubMed  Google Scholar 

  21. Fallah A, Akl EA, Ebrahim S et al (2012) Anterior cervical discectomy with arthroplasty versus arthrodesis for single-level cervical spondylosis: a systematic review and meta-analysis. PLoS One 7:e43407

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Wu AM, Xu H, Mullinix KP et al (2015) Minimum 4-year outcomes of cervical total disc arthroplasty versus fusion: a meta-analysis based on prospective randomized controlled trials. Medicine (Baltimore) 94:e665

    Article  Google Scholar 

  23. Davis RJ, Nunley PD, Kim KD et al (2015) Two-level total disc replacement with Mobi-C cervical artificial disc versus anterior discectomy and fusion: a prospective, randomized, controlled multicenter clinical trial with 4-year follow-up results. J Neurosurg Spine 22:15–25

    Article  PubMed  Google Scholar 

  24. Jia Z, Mo Z, Ding F et al (2014) Hybrid surgery for multilevel cervical degenerative disc diseases: a systematic review of biomechanical and clinical evidence. Eur Spine J 23:1619–1632

    Article  PubMed  Google Scholar 

  25. Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA (2007) Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine 6:198–209

    Article  PubMed  Google Scholar 

  26. Sasso RC, Best NM, Metcalf NH, Anderson PA (2008) Motion analysis of bryan cervical disc arthroplasty versus anterior discectomy and fusion: results from a prospective, randomized, multicenter, clinical trial. J Spinal Disord Tech 21:393–399

    Article  PubMed  Google Scholar 

  27. Tian W, Wang H, Yan K, Han X, Jin P (2014) Analysis of the factors that could predict segmental range of motion after cervical artificial disc replacement: a 7-years follow-up study. J Spinal Disord Tech

  28. Rong X, Gong Q, Liu H et al (2014) The effect of deviated center of rotation on flexion-extension range of motion after single-level cervical arthroplasty: an in vivo study. Spine (Phila Pa 1976) 39:B12–B18

    Article  Google Scholar 

  29. Gandhi AA, Kode S, DeVries NA et al (2015) Biomechanical analysis of cervical disc replacement and fusion using single level, two level and hybrid constructs. Spine (Phila Pa 1976)

  30. Chang UK, Kim DH, Lee MC et al (2007) Changes in adjacent-level disc pressure and facet joint force after cervical arthroplasty compared with cervical discectomy and fusion. J Neurosurg Spine 7:33–39

    Article  PubMed  Google Scholar 

  31. DiAngelo DJ, Foley KT, Morrow BR et al (2004) In vitro biomechanics of cervical disc arthroplasty with the ProDisc-C total disc implant. Neurosurg Focus 17:E7

    PubMed  Google Scholar 

  32. Dmitriev AE, Cunningham BW, Hu N et al (2005) Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: an in vitro human cadaveric model. Spine (Phila Pa 1976) 30:1165–1172

    Article  Google Scholar 

  33. 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 (Phila Pa 1976) 27:2431–2434

    Article  Google Scholar 

  34. Luo J, Gong M, Huang S, Yu T, Zou X (2015) Incidence of adjacent segment degeneration in cervical disc arthroplasty versus anterior cervical decompression and fusion meta-analysis of prospective studies. Arch Orthop Trauma Surg 135:155–160

    Article  PubMed  Google Scholar 

  35. Nunley PD, Jawahar A, Cavanaugh DA et al (2013) Symptomatic adjacent segment disease after cervical total disc replacement: re-examining the clinical and radiological evidence with established criteria. Spine J 13:5–12

    Article  PubMed  Google Scholar 

  36. Verma K, Gandhi SD, Maltenfort M et al (2013) Rate of adjacent segment disease in cervical disc arthroplasty versus single-level fusion: meta-analysis of prospective studies. Spine (Phila Pa 1976) 38:2253–2257

    Article  Google Scholar 

  37. Yang B, Li H, Zhang T, He X, Xu S (2012) The incidence of adjacent segment degeneration after cervical disc arthroplasty (CDA): a meta analysis of randomized controlled trials. PLoS One 7:e35032

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Aragones M, Hevia E, Barrios C (2015) 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. Eur Spine J 24:2735–2745

    Article  PubMed  Google Scholar 

  39. Shriver MF, Lubelski D, Sharma AM et al (2015) Adjacent segment degeneration and disease following cervical arthroplasty: a systematic review and meta-analysis. Spine J 16:168–181

    Article  PubMed  Google Scholar 

  40. Delamarter RB, Zigler J (2013) Five-year reoperation rates, cervical total disc replacement versus fusion, results of a prospective randomized clinical trial. Spine (Phila Pa 1976) 38:711–717

    Article  Google Scholar 

  41. Menzin J, Zhang B, Neumann P et al (2010) A health-economic assessment of cervical disc arthroplasty compared with allograft fusion. Tech Orthop 25:133–137

    Article  Google Scholar 

  42. Qureshi SA, McAnany S, Goz V, Koehler SM, Hecht AC (2013) Cost-effectiveness analysis: comparing single-level cervical disc replacement and single-level anterior cervical discectomy and fusion: clinical article. J Neurosurg Spine 19:546–554

    Article  PubMed  Google Scholar 

  43. Radcliff K, Zigler J (2015) Costs of cervical disc replacement versus anterior cervical discectomy and fusion for treatment of single-level cervical disc disease: an analysis of the Blue Health Intelligence database for acute and long-term costs and complications. Spine (Phila Pa 1976) 40:521–529

    Article  Google Scholar 

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Acknowledgments

JFB is a recipient of the Joint RCSI/Gussie Mehigan Scholarship.

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Authors and Affiliations

  1. Department of Spine and Spinal Deformity Surgery, Hospital for Joint Diseases NYU Langone Medical Center, 301 East 17th Street, New York, 10003, NY, USA

    Aaron J. Buckland, Joseph F. Baker, Ryan P. Roach & Jeffrey M. Spivak

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  1. Aaron J. Buckland
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  2. Joseph F. Baker
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  3. Ryan P. Roach
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  4. Jeffrey M. Spivak
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Correspondence to Joseph F. Baker.

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Buckland, A.J., Baker, J.F., Roach, R.P. et al. Cervical disc replacement — emerging equivalency to anterior cervical discectomy and fusion. International Orthopaedics (SICOT) 40, 1329–1334 (2016). https://doi.org/10.1007/s00264-016-3181-8

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  • DOI: https://doi.org/10.1007/s00264-016-3181-8

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