Objective: Artificial disc replacement (ADR) is designed to preserve motion and thus protect against adjacent-segment pathology (ASP) and act as an alternative treatment to fusion surgery. The question remains, how well do ADR devices perform after 10 years of follow-up compared with fusion surgery in terms of patient satisfaction, sustainability, and protection against ASP?
Methods: This was the 10-year follow-up study of 153 participants who underwent ADR or fusion surgery after anterior decompression due to cervical degenerative radiculopathy (ISRCTN registration no. 44347115). Scores on the Neck Disability Index (NDI), EQ-5D, and visual analog scale for neck and arm pain were obtained from the Swedish Spine Registry and analyzed using ANCOVA. Information about secondary surgical procedures was collected from medical records and presented as Kaplan-Meier curves. MRI and flexion-extension radiography were performed, and ASP was graded according to the Miyazaki classification system.
Results: Ten participants were lost to follow-up, which left 143 participants (80 underwent ADR and 65 underwent anterior cervical discectomy and fusion). There were no differences between groups in terms of patient-reported outcome measures (10-year difference in NDI scores 1.7 points, 95% CI -5.1 to 8.5, p = 0.61). Nineteen (24%) participants in the ADR group compared with 9 (14%) in the fusion group underwent secondary surgical procedures. The higher reoperation rate of the ADR group was mainly due to 11 female participants with device loosening. The rates of reoperation due to ASP were similar between groups, which was confirmed with MRI assessment of ASP that also showed no differences between the groups (p = 0.21).
Conclusions: This was the first 10-year follow-up study to compare ADR with fusion surgery and to provide MRI information for the assessment of ASP. The authors found no benefit of ADR over fusion surgery after anterior decompression for cervical degenerative radiculopathy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.3171/2021.9.SPINE21904 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparison of actionable alterations in cancers with kinase fusion, mutation, and copy number alteration.
PLoS One
January 2025
Cancer Center, Kagoshima University Hospital, Kagoshima, Japan.
Kinase-related gene fusion and point mutations play pivotal roles as drivers in cancer, necessitating optimized, targeted therapy against these alterations. The efficacy of molecularly targeted therapeutics varies depending on the specific alteration, with great success reported for such therapeutics in the treatment of cancer with kinase fusion proteins. However, the involvement of actionable alterations in solid tumors, especially regarding kinase fusions, remains unclear.
View Article and Find Full Text PDFTherapy Potential of Oblique Lumbar Interbody Fusion 360 for Severe Lumbar Spinal Stenosis.
Orthop Surg
January 2025
Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
Objectives: The advent of O-arm navigation optimized the oblique lumbar interbody fusion (OLIF) procedure, allowing the operator to simultaneously perform OLIF and percutaneous posterior pedicle screw implantation without patient position change, thus improving the fluency and accuracy of the OLIF procedure (called as OLIF360). Nevertheless, a consensus regarding its suitability for patients with severe spinal stenosis remains elusive. This study aims to investigate the clinical efficacy of OLIF360 and its imaging changes in severe lumbar spinal stenosis cases.
View Article and Find Full Text PDFA method for facile production of variable lymphocyte receptors using SHuffle Escherichia coli.
Biotechnol Prog
January 2025
Department of Chemical and Biological Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Variable lymphocyte receptors (VLRs) are the antigen receptors of jawless vertebrates such as lamprey. VLRs are of growing biotechnological interest for their ability to bind certain antigenic targets with higher affinity than traditional immunoglobulins. However, VLRs are disulfide-bonded proteins that are often challenging to produce requiring genetic modifications, fusion partners, non-scalable host cell lines or inclusion body formation and refolding.
View Article and Find Full Text PDFA Pilot Study of the Gut Microbiota in Spine Fusion Surgery Patients.
HSS J
February 2025
Hospital for Special Surgery, New York, NY, USA.
Background: The microbiome has been identified as a contributor to bone quality. As skeletal health is critical to success of orthopedic surgery, the gut microbiome may be a modifiable factor associated with postoperative outcomes. For spine fusion surgery in particular, bone formation and sufficient bone mineral density are essential for successful outcomes.
View Article and Find Full Text PDFAngiomatoid fibrous histiocytoma with EWSR1-CREB1 gene fusion occurs in lungs and ribs with systemic multiple metastases: a case report and review of the literature.
Front Oncol
January 2025
Department of Pathology, The First Affiliated Hospital of Dali University, Dali, Yunnan, China.
Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor with intermediate malignant potential, and it rarely metastasizes. We encountered a unique AFH case where, the tumor was discovered initially in unusual locations-the left lung and the left 4th rib. Combined histological features with FISH and NGS analysis, the diagnosis of AFH was supported, however, it is difficult to determine which of these two is the primary lesion.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!