TDR smackdown: 5 spine surgeons present clinical studies vs. ACDF

Laura Dyrda -   Print  |

There were five scientific presentations analyzing and discussing the five-year, long-term safety and efficacy of the Mobi-C Cervical Disc for both one- and two-level procedures given at the North American Spine Society Annual Meeting.

The studies included:


1. Reginald Davis, MD, of Greater Baltimore Medical Center and University of Maryland Medical Center presented outcomes from two-level total disc replacements comapred to anterior cervical discectomy and fusion. The research found patients maintained segmental range of motion through 60 months, whereas patients who underwent ACDF had motion eliminated. The disc replacement patients also had better NDI scores, VAS scores, patient satisfaction and rate of subsequent surgeries at 60 months.


2. Michael Hisey, MD, of Texas Back Institute, presented a study with five year results from a prospective randomized clincial trial comparing one-level total disc repalcement with ACDF. The researchers found disc replacement patients experineced less pain, higher function levels and better quality of life. There were also fewer device-related interventions at 60 months for disc replacement patients: 3.4 percent for disc replacement, compared with 12.3 percent for ACDF.


3. Robert Jackson, MD, of Orange County Neurosurgical Associates, presented a study on subsequent surgery rates after treatment with total disc replacement and ACDF at both one and two levels. The researchers found patients who underwent total disc replacement experienced less adjacent segment degeneration and less additional surgery at the index and adjacent levels.


4. Pierce Nunley, MD, of the Spine Institute of Louisiana, presented a study examining the radiographic adjacent segment pathology after treatment with total disc replacement. The study authors concluded one-level cervical disc replacement patients have less RASP than ACDF patients at 60 months and the difference between cervical TDR and ACDF at two-levels is even more pronouce after two years. Additionally, the greatest changes in RASP (D3 and D4) were observed almost exclusively with ACDF.


5. Hyun Bae, MD, of The Spine Institute in Santa Monica and The Spine Center at Cedars Sinai Medical Center, presented a study comparing total disc replacement to ACDF at one and two levels. He found no statistically significant reduction in efficacy or complication increase when operating on more levels with the disc replacement procedure while ACDF patients had reduced effectiveness when multiple levels were fused. Long term results of the total disc replacement for Mobi-C IDE clinical trial continue to show safety and efficacy.

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