A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration

2010 ◽  
Vol 28 (6) ◽  
pp. E5 ◽  
Author(s):  
Ricardo Vieira Botelho ◽  
Osmar José dos Santos Moraes ◽  
Gustavo Alberto Fernandes ◽  
Yuri dos Santos Buscariolli ◽  
Wanderley Marques Bernardo
Keyword(s):  
Systematic Review ◽  
Statistical Significance ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Adjacent Segment ◽  
Number Needed To Treat ◽  
Adjacent Level ◽  
Cervical Arthroplasty ◽  
Disc Arthroplasty ◽  
Adjacent Level Degeneration

Object Anterior cervical discectomy and fusion had been considered a safe and effective procedure for radiculopathy and myelopathy in the cervical spine, but degeneration in adjacent spinal levels has been a problem in some patients after fusion. Since 2002, cervical disc arthroplasty has been established as an alternative to fusion. The objective of this study was to review data concerning the role of cervical arthroplasty in reducing adjacent-level degeneration. Methods A systematic review was performed using the MEDLINE, EMBASE, Cochrane, and LILACS databases, focusing on a structured question involving the population of interest, types of intervention, types of control, and outcomes studied. Results No study has specifically compared the results of arthroplasty with the results of fusion with respect to the rate of postoperative development of adjacent-segment degenerative disease. One paper described a rate for adjacent-level surgery. The level of evidence of that paper was classified 2b, and although its authors found a statistically significant between-groups difference (arthroplasty vs fusion) using log-rank analysis, re-analysis according to number needed to treat (in the current paper) did not reveal statistical significance. Conclusions Adjacent-level degeneration has not been adequately studied in a review of the available randomized controlled trials on this topic, and there is no clinical evidence of reduction in adjacent-level degeneration with the use of cervical arthroplasty.

scholarly journals Adverse Events Following Cervical Disc Arthroplasty: A Systematic Review

2017 ◽  
Vol 8 (2) ◽  
pp. 178-189 ◽  
Author(s):  
Jordan C. Xu ◽  
Chandni Goel ◽  
Michael F. Shriver ◽  
Joseph E. Tanenbaum ◽  
Michael P. Steinmetz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Industry Funding ◽  
Quality Of Reporting ◽  
Cervical Arthroplasty ◽  
Disc Arthroplasty ◽  
Vascular Compromise

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.

scholarly journals Adjacent-level degeneration after cervical disc arthroplasty versus fusion

2011 ◽  
Vol 20 (S3) ◽  
pp. 403-407 ◽  
Author(s):  
Carlos Valencia Maldonado ◽  
Ricardo Díaz-Romero Paz ◽  
Claudia Balhen Martin
Keyword(s):  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Adjacent Level ◽  
Disc Arthroplasty ◽  
Adjacent Level Degeneration

Ten-Year Outcomes of 1- and 2-Level Cervical Disc Arthroplasty From the Mobi-C Investigational Device Exemption Clinical Trial

Neurosurgery ◽  
2020 ◽  
Author(s):  
Kee Kim ◽  
Greg Hoffman ◽  
Hyun Bae ◽  
Andy Redmond ◽  
Michael Hisey ◽  
...  
Keyword(s):  
Neck Disability Index ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Adjacent Segment ◽  
Disc Disease ◽  
Cervical Arthroplasty ◽  
Disc Arthroplasty ◽  
Arm Pain ◽  
Pain Outcomes ◽  
Neck Disability

Abstract BACKGROUND Short- and mid-term studies have shown the effectiveness of cervical disc arthroplasty (CDA) to treat cervical disc degeneration. OBJECTIVE To report the 10-yr outcomes of a multicenter experience with cervical arthroplasty for 1- and 2-level pathology. METHODS This was a prospective study of patients treated with CDA at 1 or 2 contiguous levels using the Mobi-C® Cervical Disc (Zimmer Biomet). Following completion of the 7-yr Food and Drug Administration postapproval study, follow-up continued to 10 yr for consenting patients at 9 high-enrolling centers. Clinical and radiographic endpoints were collected out to 10 yr. RESULTS At 10 yr, patients continued to have significant improvement over baseline Neck Disability Index (NDI), neck and arm pain, neurologic function, and segmental range of motion (ROM). NDI and pain outcomes at 10 yr were significantly improved from 7 yr. Segmental and global ROM and sagittal alignment also were maintained from 7 to 10 yr. Clinically relevant adjacent segment pathology was not significantly different between 7 and 10 yr. The incidence of motion restricting heterotopic ossification at 10 yr was not significantly different from 7 yr for 1-level (30.7% vs 29.6%) or 2-level (41.7% vs 39.2%) patients. Only 2 subsequent surgeries were reported after 7 yr. CONCLUSION Our results through 10 yr were comparable to 7-yr outcomes, demonstrating that CDA with Mobi-C continues to be a safe and effective surgical treatment for patients with 1- or 2-level cervical degenerative disc disease.

scholarly journals History of cervical disc arthroplasty

2009 ◽  
Vol 27 (3) ◽  
pp. E10 ◽  
Author(s):  
Ali A. Baaj ◽  
Juan S. Uribe ◽  
Fernando L. Vale ◽  
Mark C. Preul ◽  
Neil R. Crawford
Keyword(s):  
Cervical Spine ◽  
Load Transfer ◽  
The Other ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Adjacent Segment ◽  
Cervical Arthroplasty ◽  
Disc Arthroplasty ◽  
History Of ◽  
Adjacent Segments

Enthusiasm for cervical disc arthroplasty is based on the premise that motion-preserving devices attenuate the progression of adjacent-segment disease (ASD) in the cervical spine. Arthrodesis, on the other hand, results in abnormal load transfer on adjacent segments, leading to the acceleration of ASD. It has taken several decades of pioneering work to produce clinically relevant devices that mimic the kinematics of the intervertebral disc. The goal of this work is to trace the origins of cervical arthroplasty technology and highlight the attributes of devices currently available in the market.

Spondylolisthesis adjacent to a cervical disc arthroplasty does not increase the risk of adjacent level degeneration

2018 ◽  
Vol 27 (6) ◽  
pp. 1440-1446
Author(s):  
David Christopher Kieser ◽  
Derek Thomas Cawley ◽  
Cecile Roscop ◽  
Simon Mazas ◽  
Pierre Coudert ◽  
...  
Keyword(s):  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Adjacent Level ◽  
Disc Arthroplasty ◽  
Adjacent Level Degeneration
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