Cervical Disk Replacement With Discover Versus Fusion in a Single-Level Cervical Disk Disease

Rožanković, Marjan; Marasanov, Sergej; Vukić, Miroslav

doi:10.1097/bsd.0000000000000170

Cited by 40 publications

(20 citation statements)

References 45 publications

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“…CDR can preserve motion in segments at the implantation site and reduce stress on the adjacent levels. 3,8,[10][11][12][13][14][15] However, the postoperative biomechanical changes after CDR are still not clearly understood. While CDR is typically associated with fewer complications than ACDF, HO can be a significant postoperative issue.…”

Section: Discussionmentioning

confidence: 99%

Quantitative analysis of the correlation between preoperative cervical degeneration and postoperative heterotopic ossification after cervical disc replacement: minimum 10-year follow-up data

Zhou

Zhao

et al. 2020

Journal of Neurosurgery: Spine

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OBJECTIVEThe authors aimed to identify factors that may be useful for quantifying the amount of degenerative change in preoperative patients to identify ideal candidates for cervical disc replacement (CDR) in patients with a minimum of 10 years of follow-up data.METHODSDuring the period from December 2003 to August 2008, 54 patients underwent CDR with a Bryan cervical disc prosthesis performed by the same group of surgeons, and all of the patients in this group with at least 10 years of follow-up data were enrolled in this retrospective analysis of cases. Postoperative bone formation was graded in radiographic images by using the McAfee classification for heterotopic ossification. Preoperative degeneration was evaluated in radiographs based on a quantitative scoring system. After univariate analysis, the authors performed multifactor logistic regression analysis to identify significant factors. To determine the cutoff points for the significant factors, a receiver operating characteristic (ROC) curve analysis was conducted.RESULTSStudy patients had a mean age of 43.6 years and an average follow-up period of 120.3 months. The patients as a group had a 68.2% overall incidence of bone formation. Based on univariate analysis results, data for patient sex, disc height, and the presence of anterior osteophytes and endplate sclerosis were included in the multivariate analysis. According to the analysis results, the identified independent risk factors for postoperative bone formation included disc height, the presence of anterior osteophytes, and endplate sclerosis, and according to a quantitative scoring system for degeneration of the cervical spine based on these variables, the ROC curve indicated that the optimal cutoff scores for these risk factors were 0.5, 1.5, and 1.5, respectively.CONCLUSIONSAmong the patients who were followed up for at least 10 years after CDR, the incidence of postoperative bone formation was relatively high. The study results indicate that the degree of degeneration in the target level before surgery has a positive correlation with the incidence of postoperative ossification. Rigorous indication criteria for postoperative ossification should be applied in patients for whom CDR may be a treatment option.

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Section: Discussionmentioning

confidence: 99%

Quantitative analysis of the correlation between preoperative cervical degeneration and postoperative heterotopic ossification after cervical disc replacement: minimum 10-year follow-up data

Zhou

Zhao

et al. 2020

Journal of Neurosurgery: Spine

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“…21,[26][27][28]33,45,46 All other remaining studies did not report how they graded AE severity. 19,22,25,31,32,[37][38][39][40][41][42][43]…”

Section: Issues With Ae Methodology and Reporting Qualitymentioning

confidence: 99%

“…20,21,[23][24][25][26]31,[33][34][35][36] Eight separate RCTs, all completed internationally, reported no industry funding or did not make any disclosures. [37][38][39][40][41][42][43][44] As part of the FDA evaluation, AE reporting is required, whether the AEs appear related to the procedure or not. Nearly all (25 out of 29) of the reviewed articles reported at least one AE, but there was a lack of standardization regarding AE definitions, collection methods, or categorization.…”

Section: Study Characteristicsmentioning

confidence: 99%

Adverse Events Following Cervical Disc Arthroplasty: A Systematic Review

Goel

Shriver

et al. 2017

Global Spine Journal

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Study Design:Systematic review.Objectives:Cervical arthroplasty is an increasingly popular treatment of cervical radiculopathy and myelopathy. An understanding of the potential adverse events (AEs) is important to help both clinicians and patients. We sought to provide a comprehensive systematic review of the AEs reported in all randomized controlled trials (RCTs) of cervical disc arthroplasty in an attempt to characterize the quality of reporting.Methods:We conducted a systematic review of MEDLINE and Web of Science for RCTs of cervical disc arthroplasty reporting AEs. We reported the most frequently mentioned AEs, including dysphagia/dysphonia, vascular compromise, dural injury, and infections. We recorded the presence of industry funding and scored the quality of collection methods and reporting of AEs.Results:Of the 3734 identified articles, 29 articles met full inclusion criteria. The quality of AE reporting varied significantly between studies, and a combined meta-analysis was not feasible. The 29 articles covered separate 19 RCTs. Eight studies were US Food and Drug Administration (FDA) investigational device exemption (IDE) trials. Rates were recorded for the following AEs: dysphagia/dysphonia (range = 1.3% to 27.2%), vascular compromise (range = 1.1% to 2.4%), cervical wound infection (range = 1.2% to 22.5%), and cerebrospinal fluid leak (range = 0.8% to 7.1%).Conclusions:There is a lack of consistency in reporting of AEs among RCTs of cervical arthroplasty. FDA IDE trials scored better in AE event reporting compared to other studies. Standardized definitions for AEs and standardized data collection methodology are needed to improve future studies.

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“…Four articles report a statistically significant difference between the prosthesis and fusion in favour of the prosthesis [46, 50, 51, 57] (Table 6). [48] 6* *** ** -* Riina [49] 4* ** * -* Rožanković [50] 4* ** * * -Sasso [51] 3* ** * --Sasso [52] 2* ** ---Steinmetz [53] 2* ** ---Vaccaro [54] 4* *** --* Wang [55] 4* ** * -* Yan [56] 3* ** * --Zhang [57] 5* *** ** --…”

Section: Vas Neck Pain In Articles Describing Mixed Patient Populationsmentioning

confidence: 99%

Cervical radiculopathy: is a prosthesis preferred over fusion surgery? A systematic review

et al. 2019

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Background Meta-analyses on the comparison between fusion and prosthesis in the treatment of cervical radiculopathy mainly analyse studies including mixed patient populations: patients with radiculopathy with and without myelopathy. The outcome for patients with myelopathy is different compared to those without. Furthermore, apart from decompression of the spinal cord, restriction of motion is one of the cornerstones of the surgical treatment of spondylotic myelopathy. From this point of view, the results for arthroplasty might be suboptimal for this category of patients. Comparing clinical outcome in patients exclusively suffering from radiculopathy is therefore a more valid method to compare the true clinical effect of the prosthesis to that of fusion surgery. Aim The objective of this study was to compare clinical outcome of cervical arthroplasty (ACDA) to the clinical outcome of fusion (ACDF) after anterior cervical discectomy in patients exclusively suffering from radiculopathy, and to evaluate differences with mixed patient populations. Methods A literature search was completed in PubMed, EMBASE, Web of Science, COCHRANE, CENTRAL and CINAHL using a sensitive search strategy. Studies were selected by predefined selection criteria (i.a.) patients exclusively suffering from cervical radiculopathy), and risk of bias was assessed using a validated Cochrane Checklist adjusted for this purpose. An additional overview of results was added from articles considering a mix of patients suffering from myelopathy with or without radiculopathy. Results Eight studies were included that exclusively compared intervertebral devices in radiculopathy patients. Additionally, 29 articles concerning patients with myelopathy with or without radiculopathy were studied in a separate results table. All articles showed intermediate to high risk of bias. There was neither a difference in decrease in mean NDI score between the prosthesis (20.6 points) and the fusion (20.3 points) group, nor was there a clinically important difference in neck pain (VAS). Comparing these data to the mixed population data demonstrated comparable mean values, except for the 2-year follow-up NDI values in the prosthesis group: mixed group patients that received a prosthesis reported a mean NDI score Electronic supplementary material The online version of this article (

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Cervical Disk Replacement With Discover Versus Fusion in a Single-Level Cervical Disk Disease

Abstract: The Discover artificial cervical disc replacement offers favorable outcome compared with ACDF for a single-level cervical disk disease at short-term and long-term follow-up.

Cited by 40 publications

References 45 publications

Quantitative analysis of the correlation between preoperative cervical degeneration and postoperative heterotopic ossification after cervical disc replacement: minimum 10-year follow-up data

Quantitative analysis of the correlation between preoperative cervical degeneration and postoperative heterotopic ossification after cervical disc replacement: minimum 10-year follow-up data

Adverse Events Following Cervical Disc Arthroplasty: A Systematic Review

Cervical radiculopathy: is a prosthesis preferred over fusion surgery? A systematic review

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