To prospectively assess the intermediate and long-term radiographic characteristics of disc replacement surgery with the Bryan® Cervical Disc, and to correlate these results with clinical outcome.
Range of motion was measured using a validated tool. Intervertebral disc degeneration was assessed using a quantitative scoring system. Heterotopic ossification was evaluated using a previously published scoring system. Device stability was investigated by measuring subsidence and anteroposterior migration. General clinical patient outcome was assessed using Odom’s classification system.
89 patients were initially included in this prospective long-term study. One patient was reoperated at the index level and four at an adjacent level: those patients were not further analyzed. The mobility at treated level was preserved in ≥85% of our cases. The insertion of the prosthesis did not lead to an increase in mobility at the adjacent levels. The degeneration score increased at both adjacent levels. Heterotopic ossification was present in 34-39% of the cases depending on the follow-up point. No cases of anteroposterior migration or of subsidence were found. More than 82% of all patients had a good to excellent clinical outcome on the long run.
The device maintains preoperative motion at the index and adjacent levels, seems to protect against acceleration of adjacent level degeneration as seen after anterior cervical discectomy and fusion, and remains securely anchored in the adjacent bone mass on the long run. Heterotopic ossification was frequently seen. The vast majority of all patients had a good to excellent clinical outcome
Walraevens J., Demaerel P., Suetens P., van Loon J., Van Calenbergh F., Vander Sloten J., Goffin J., ''Longitudinal prospective long-term radiographic follow-up after treatment of single-level cervical disc disease with the Bryan® Cervical Disc'', Neurosurgery, vol. 67, no. 3, pp. 679-687, September 2010.