Abstract | BACKGROUND: METHODS: Two hundred and nine patients at thirteen sites were randomly treated with either total disc arthroplasty with ProDisc-C (n = 103) or with ACDF (n = 106). Patients were assessed preoperatively; at six weeks and three, six, twelve, eighteen, and twenty-four months postoperatively; and then annually until seven years postoperatively. Outcome measures included the Neck Disability Index (NDI), the Short Form-36 (SF-36), postoperative neurologic parameters, secondary surgical procedures, adverse events, neck and arm pain, and satisfaction scores. RESULTS: At seven years, the overall follow-up rate was 92% (152 of 165). There were no significant differences in demographic factors, follow-up rate, or patient-reported outcomes between groups. Both procedures were effective in reducing neck and arm pain and improving and maintaining function and health-related quality of life. Neurologic status was improved or maintained in 88% and 89% of the patients in the ProDisc-C and ACDF groups, respectively. After seven years of follow-up, thirty secondary surgical procedures had been performed in nineteen (18%) of 106 patients in the ACDF group compared with seven secondary surgical procedures in seven (7%) of 103 patients in the ProDisc-C group (p = 0.0099). There were no significant differences in the rates of any device-related adverse events between the groups. CONCLUSIONS: LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Authors | Michael E Janssen, Jack E Zigler, Jeffrey M Spivak, Rick B Delamarter, Bruce V Darden 2nd, Branko Kopjar |
Journal | The Journal of bone and joint surgery. American volume
(J Bone Joint Surg Am)
Vol. 97
Issue 21
Pg. 1738-47
(Nov 04 2015)
ISSN: 1535-1386 [Electronic] United States |
PMID | 26537161
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)
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Copyright | Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated. |
Topics |
- Adult
- Cervical Vertebrae
- Device Approval
- Diskectomy
- Female
- Follow-Up Studies
- Humans
- Intervertebral Disc Degeneration
(surgery)
- Male
- Middle Aged
- Product Surveillance, Postmarketing
- Prospective Studies
- Prostheses and Implants
- Spinal Fusion
- Time Factors
- Total Disc Replacement
- Treatment Outcome
- United States
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