Objective: To compare the clinical outcomes of single level Bryan cervical disc replacement with traditional anterior cervical discectomy and fusion (ACDF).
Methods: From Dec 2003 to May 2005, 59 patients with primary, single-level cervical radiculopathy and/or myelopathy were prospectively randomized into 2 groups: Bryan group with artificial disc replacement and ACDF group with traditional anterior cervical discectomy and fusion. Operation time, blood loss and hospitalization duration were compared between the 2 groups. Follow-up was taken at six weeks, 3, 6, 12 and 24 months after operation, and each case in both groups was evaluated with serial radiographic studies, neck disability indices (NDI), visual analog scale scores (VAS) for arm and neck pain.
Results: No difference was found in the operation time, intraoperative blood loss and hospital stay between the 2 groups. But at the follow-up of 6 weeks and 3 months after operation, significant difference in NDI and VAS of neck pain existed. All replaced segments remained normal range of motion in sagittal rotation, while no motion occurred in any of the fusion segments. In ACDF group movement of the whole cervical spine decreased but gradually recovered to preoperative level in 6 months after operation. In Bryan group, pre- and postoperative motion of the whole cervical spine remained unchanged at any of the follow-up time.
Conclusions: Bryan disc replacement can achieve similar clinical improvement compared with traditional ACDF. Arthroplasty has the advantages of motion maintenance for the cervical spine and short recovery time after operation.