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Sagittal alignment comparison of Bryan disc arthroplasty with ProDisc-C arthroplasty: a prospective, randomized

Zhao Yanbin¹, Sun Yu, Chen Zhongqiang

¹Department of Orthopedic Surgery, Peking University Third Hospital, Beijing, China.

Journal of Spinal Disorders & Techniques

|December 15, 2010

Abstract

Study Design:

A prospective, randomized study of the radiographic outcomes in patients undergoing single-level cervical arthroplasty with Bryan disc and ProDisc-C prosthesis.

Objective:

The purpose of this trial was to compare the alignment changes of Bryan disc arthroplasty (modified techniques) with ProDisc-C arthroplasty.

Summary Of Background Data:

Aggravation of kyphosis is the known challenge after Bryan disc arthroplasty. Both Bryan disc arthroplasty with modified techniques and ProDisc-C arthroplasty were reported to avoid the postoperative local kyphosis. There have been no studies comparing the alignment changes after Bryan disc arthroplasty with ProDisc-C arthroplasty.

Methods:

We conducted a randomized controlled clinical trial enrolling patients with cervical disc disease. Ultimately 20 patients received Bryan disc arthroplasty with modified surgical techniques and 26 patients received ProDisc-C arthroplasty. Functional spinal unit (FSU) and overall cervical alignment (Cobb angle of C2/7) were compared at final follow-up.

Results:

(1) FSU angle: the FSU angle was maintained for the Bryan disc group (from 0.8 to 0.6 degrees) without statistical significance; the FSU angle increased 2.9 degrees for the ProDisc-C group (from -0.3 to 2.6 degrees) with statistical significance. (2) Overall alignment: the overall alignments did not change for both Bryan disc and ProDisc-C groups.

Conclusions:

Bryan disc arthroplasty with modified techniques can maintain the lordosis of FSU, whereas ProDisc-C arthroplasty can restore the lordosis of FSU. For the patients with preoperative FSU kyphosis, ProDisc-C arthroplasty may be a better choice to restore the lordosis.

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