title: Comparison of adjacent segment degeneration five years after single level cervical fusion and cervical arthroplasty: a retrospective controlled study.
abstract: BACKGROUND
  Cervical arthroplasty is indicated to preserve cervical motion and prevent accelerated adjacent segment degeneration. Whether accelerated adjacent segment degeneration is prevented in the long term is unclear. This trial compared adjacent segment degeneration in Bryan disc arthroplasty with that in anterior cervical decompression and fusion five years after the surgery.
  
  
  METHODS
  We studied patients with single level degenerative cervical disc disease. The extent of adjacent segment degeneration was estimated from lateral X-rays.
  
  
  RESULTS
  Twenty-six patients underwent single level Bryan disc arthroplasty and twenty-four patients underwent single level anterior cervical decompression and fusion. All patients were followed up for an average of sixty months. In the Bryan arthroplasty group, nine (17.6%) segments developed adjacent segment degeneration, which was significantly lower than that (60.4%) in the anterior cervical decompression and fusion group. Eleven segments in the Bryan arthroplasty group developed heterotopic ossification according to McAfee's classification and two segments had range of motion less than 2°. In the heterotopic ossification group, four (19.5%) segments developed adjacent segment degeneration, similar to the number in the non-heterotopic ossification group (16.7%). Adjacent segment degeneration rate was 50% in grade IV group but 11.8% in grade II to III.
  
  
  CONCLUSIONS
  Adjacent segment degeneration was accelerated after anterior cervical decompression and fusion. However, Bryan disc arthroplasty avoided accelerated adjacent segment degeneration by preserving motion. Patients with grade IV heterotopic ossification lost motion, and the rate of adjacent segment degeneration was higher than that in patients without heterotopic ossification.
authors.affiliation: Department of Orthopaedic Surgery, Peking University Third Hospital, Beijing, China. sunyuor@yahoo.cn
authors.forename: Yu
authors.initials: Y
authors.lastname: Sun
authors.forename: Yan-bin
authors.initials: YB
authors.lastname: Zhao
authors.forename: Sheng-fa
authors.initials: SF
authors.lastname: Pan
authors.forename: Fei-fei
authors.initials: FF
authors.lastname: Zhou
authors.forename: Zhong-qiang
authors.initials: ZQ
authors.lastname: Chen
authors.forename: Zhong-jun
authors.initials: ZJ
authors.lastname: Liu
mesh_terms: D000328:Adult; D001178:Arthroplasty / Q000009:adverse effects*; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects*; D055815:Young Adult