#127 Comparison of Adjacent Segment Degeneration Five Years After Single-level Cervical Fusion and Cervical Arthroplasty: A Retrospective Controlled Study

General Session: Cervical - Clinical Outcomes

Presented by: Z. Yanbin

Author(s):

Z. Yanbin (1)
S. Yu (1)

(1) Peking University Third Hospital, Beijing, China

Abstract

Background: Cervical arthroplasty was indicated to preserve cervical motion and to prevent accelerated adjacent segment degeneration(ASD). The motion was well preserved after cervical arthroplasty. But, it is not clear whether the accelerated ASD was prevented or not in long-term follow-up. The purpose of this trial is to compare the ASD of Bryan disc arthroplasty with anterior cervical decompression and fusion (ACDF) five years after the surgery.

Methods: We conducted a retrospective study enrolling patients with single-level degenerative cervical disc disease. ASDs were compared on lateral X-ray.

Results: Ultimately 26 patients received single-level Bryan disc arthroplasty and 24 patients received single-level ACDF were followed up with average 60 months.1)In the Bryan arthroplasty group, 9 (17.6%) segments developed ASDs, which was significantly lower than the ACDF group (60.4%); 2) 11 (42.3%) segments developed heterotopic ossification (HO) of Bryan arthroplasty group according to McAfee's classification and 2 segments lost motion(range of motion < 2°). In the HO group, 4(19.5%) segments developed ASDs, which was similar to the no-HO group of 16.7%. The ratio of ASD of these two patients with grade Ⅳ HO was 50%;3) 24 (100%) segments gained bony fusion of the ACDF group at final follow-up.

Conclusions: ASD was accelerated after ACDF. But, Bryan disc arthroplasty avoided the accelerated ASD by preserving motions. Patients with grade Ⅳ HO lost motion and the rate of ASD was higher than the patients without HO.