A new study published in the Journal of Spinal Disorders & Techniques examines cervical total disc replacement compared with anterior cervical fusion with a 48-month follow-up.
There were 23 centers included in the study with 164 patients who underwent cervical disc replacement with the Mobi-C cervical disc prosthesis and 81 patients who underwent anterior cervical discectomy and fusion with an anterior plate and allograft. The researchers found:
1. These scores were similar between the two groups, with significant improvement early on and the success was maintained through 48 months:
- Neck disability index
- Visual analog scale
- SF-12 scores
2. There were a few measures where total disc replacement had significnatly greater imiprovement during the early follow-up period.
3. None of the disc replacement scores at any period in the follow-up schedule was significantly worse than the fusion scores.
4. The subsequent surgery rate was significantly higher for ACDF when compared with total discreplacement; fusion had a 9.9 percent second surgery rate, compared with 3 percent for disc replacement.
5. Total disc replacement patients maintained their range of motion with an average baseline value of eight degrees, compared with 10 degreees at 48 months.
6. Adjacent-segment degeneration was significantly higher with fusion at inferior and superior segments when compared with disc replacement:
- Fusion inferior: 50 percent
- Fusion superior: 53 percent
- Disc replacement inferior: 30 percent
- Disc replacement superior: 34 percent
"This study supports the safety and efficacy of TDR in appropriately-selected patients," concluded the study authors.