Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial

Spine (Phila Pa 1976). 2009 Jan 15;34(2):101-7. doi: 10.1097/BRS.0b013e31818ee263.


Study design: A prospective, randomized, multicenter study of surgical treatment of cervical disc disease.

Objective: To assess the safety and efficacy of cervical disc arthroplasty using a new arthroplasty device at 24-months follow-up.

Summary of background data: Cervical disc arthroplasty preserves motion in the cervical spine. It is an alternative to fusion after neurologic decompression, whereas anterior decompression and fusion provides a rigorous comparative benchmark of success.

Methods: We conducted a randomized controlled multicenter clinical trial enrolling patients with cervical disc disease. Ultimately 242 received the investigational device (Bryan Cervical Disc), and 221 patients underwent a single-level anterior cervical discectomy and decompression and fusion as a control group. Patients completed clinical and radiographic follow-up examinations at regular intervals for 2 years after surgery.

Results: Analysis of 12- and 24-month postoperative data showed improvement in all clinical outcome measures for both groups; however, 24 months after surgery, the investigational group patients treated with the artificial disc had a statistically greater improvement in the primary outcome variables: Neck disability index score (P = 0.025) and overall success (P = 0.010). With regard to implant- or implant/surgical-procedure-associated serious adverse events, the investigational group had a rate of 1.7% and the control group, 3.2%. There was no statistical difference between the 2 groups with regard to the rate of secondary surgical procedures performed subsequent to the index procedure. Patients who received the artificial cervical disc returned to work nearly 2 weeks earlier than the fusion patients (P = 0.015).

Conclusion: Two-year follow-up results indicate that cervical disc arthroplasty is a viable alternative to anterior cervical discectomy and fusion in patients with persistently symptomatic, single-level cervical disc disease.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arthroplasty / instrumentation*
  • Arthroplasty / methods
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / pathology
  • Cervical Vertebrae / surgery*
  • Decompression, Surgical / statistics & numerical data
  • Diskectomy / statistics & numerical data
  • Endpoint Determination
  • Female
  • Humans
  • Intervertebral Disc / diagnostic imaging
  • Intervertebral Disc / pathology
  • Intervertebral Disc / surgery*
  • Intervertebral Disc Displacement / diagnostic imaging
  • Intervertebral Disc Displacement / pathology
  • Intervertebral Disc Displacement / surgery*
  • Male
  • Middle Aged
  • Neurosurgical Procedures / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Prostheses and Implants / trends*
  • Radiography
  • Spinal Fusion / statistics & numerical data
  • Treatment Outcome