Age, injury, poor posture or diseases, such as arthritis, can lead to degeneration of the bones or joints of the cervical spine. This, in turn, can cause disc herniation or bone spurs to form. Although some patients can be treated effectively through conservative, non-surgical methods, many will require surgery. And a large portion of the patients who undergo cervical spine surgery will have a spinal fusion, or arthrodesis, performed.

Spinal fusion is an operation that creates a solid union between two or more vertebrae. Various devices, such as screws or plates, may be used to enhance fusion and support unstable areas of the cervical spine. This procedure may assist in strengthening and stabilizing the spine and, consequently, may help alleviate severe and chronic neck pain.

Researchers recently compared return-to-work data for a total of 972 patients undergoing cervical disc surgery through spinal fusion, as well as replacement with two different types of artificial discs. The results of this study, titled “Return to Work Analysis of Patients Treated with an Artificial Cervical Disc or an Arthrodesis,” was presented by Vincent C. Traynelis, MD, at the recent annual meeting of the American Association of Neurological Surgeons in San Francisco.

Artificial cervical discs were developed and approved for use outside the United States in the last decade. In the U.S., both the Bryan® cervical disc system and Prestige™ cervical disc system have undergone comprehensive U.S. FDA-approved Investigational Device Exemption clinical trials in the last two years. These artificial discs are designed to replace a diseased disc that is removed from a patient’s cervical spine and to maintain or restore spine flexibility.

“From both a medical and economic standpoint, it is important to analyze the efficacy of cervical spine surgery,” says Traynelis. Both studies prospectively followed patients with single-level symptomatic cervical spinal disc disease who failed to respond to conservative non-surgical treatment. Patients were randomized to be treated with a disc excision followed by either a fusion or placement of either the Bryan or Prestige artificial disc.

The first group included 240 patients who received a Bryan artificial cervical spinal disc replacement and 222 patients who underwent fusion. The second group consisted of 250 patients who received a Prestige artificial cervical disc replacement and 260 individuals who underwent fusion.

Both devices provide spinal stability and allow for normal motion. A fusion provides stability but eliminates spinal motion across the segments, which are fused. In both studies, the group of patients receiving an artificial disc was statistically similar to the group of patients receiving a fusion (i.e., age, sex and associated medical conditions).

Source: American Association of Neurological Surgeons