Comparison of Clinical and Radiographic Changes after Bryan Disc Arthroplasty versus ACDF: A 60-Month Follow-Up on 120 Patients

Background: Artificial cervical disc replacement has become an option for cervical radiculopathy. Previous studies have evaluated the efficacy of this alternative without the scientific rigor of a concurrent control population in oriental patients for long-term follow-up. Objective: Therefore, we asked whether the 1) clinical and 2) radiographic outcomes of Bryan cervical disc prosthesis were better than that of anterior cervical discectomy and fusion (ACDF) at single site, and whether the 3) occurrences of heterotopic ossifications (HOs) were associated to the function loss in the long-term follow-up. Methods: A total of 120 patients with cervical disc disease were randomly assigned to two groups (Bryan or ACDF), and 60-month follow-up is available for all the 120 patients. Clinical outcomes were assessed using Odom’s criteria, visual analogue pain scale (VAS) and Neck Disability Index (NDI). Radiographs were measured to determine the radiographic outcomes and occurrences of heterotopic ossifications (HOs). Results: The clinical outcomes are not significantly between the two groups (VAS, P = 0.7253; NDI, P = 0.5528). The radiographic outcome of Bryan cervical disc prosthesis is better than that of ACDF group at the index level (P < 0.05). 36 (60%) patients of Bryan group developed heterotopic ossification. But, there is not a significant association between HOs and the loss of movement at the replacement level. Conclusions: The Bryan artificial disc replacement compares favorably to ACDF for the treatment of patients with 1-level cervical disc disease. And the Bryan disc may delay adjacent level degeneration by preserving preoperative kinematics at adjacent levels in oriental patients. Co-first author. Corresponding author.