Analysis of Return-to-Work Data Provides Insight into Cervical Spine Surgery Efficacies

Newswise — Age, injury, poor posture, or diseases such as arthritis can lead to degeneration of the bones or joints of the cervical spine, causing disc herniation or bone spurs to form. Often, patients can be treated effectively through conservative, nonsurgical methods, but many will require surgery. Many of the patients who undergo cervical spine surgery will have a spinal fusion (arthrodesis) performed. Spinal fusion is an operation that creates a solid union between two or more vertebrae. Various devices (like screws or plates) may be used to enhance fusion and support unstable areas of the cervical spine. This procedure may assist in strengthening and stabilizing the spine and may thereby help to alleviate severe and chronic neck pain.

Researchers recently compared return-to-work data for a total of 972 patients undergoing cervical disc surgery through spinal fusion, as well as replacement with two different types of artificial discs. The results of this study, Return to Work Analysis of Patients Treated with an Artificial Cervical Disc or an Arthrodesis, will be presented by Vincent C. Traynelis, MD, 4:15 to 4:30 p.m. on Monday, April 24, 2006, during the 74th Annual Meeting of the American Association of Neurological Surgeons in San Francisco. Co-authors are Paul A. Anderson, MD and Newton H. Metcalf, BS.

Artificial cervical discs were developed and approved for use outside the United States in the last decade. In the United States, both the BRYAN® Cervical Disc System and PRESTIGE™ Cervical Disc System have undergone comprehensive FDA-approved Investigational Device Exemption (IDE) clinical trials in the last two years. These artificial discs are designed to replace a diseased disc that is removed from a patient's cervical spine and to maintain or restore spine flexibility.

"From both a medical and economic standpoint, it is important to analyze the efficacy of cervical spine surgery," stated Dr. Traynelis. Both studies prospectively followed patients with single-level symptomatic cervical spinal disc disease who failed to respond to conservative nonsurgical treatment. Patients were randomized to be treated with a disc excision followed by either a fusion or placement of either the Bryan or Prestige artificial disc.

The Bryan group included 240 patients who received a Bryan artificial cervical spinal disc replacement and 222 patients who underwent fusion. The Prestige group consisted of 250 patients who received a Prestige artificial cervical disc replacement and 260 individuals who underwent fusion.

Both devices provide spinal stability and allow for normal motion. A fusion provides stability but eliminates spinal motion across the segments which are fused. In both studies, the group of patients receiving an artificial disc was statistically similar to the group of patients receiving a fusion (age, sex, associated medical conditions, etc.).

The following outcomes were noted:

"¢Bryan Group: Median return to work was 50 days for the artificial disc group, and was 74 days for the spinal fusion group.

"¢Prestige Group: Median return to work was 46 days for the artificial disc group, and was 63 days for the spinal fusion group.

"The data from these two studies, comprised of a total of 972 patients, shows that patients treated with an artificial cervical disc return to work more rapidly than those treated with a fusion, with statistically significant differences," stated Dr. Traynelis.

Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 6,800 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain and peripheral nerves.

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