Subjective and Objective Quality-of-Life Assessment of Outcome Measures in Cervical Spine Surgery for Degenerative Changes

Marek Prokopienko; Michał Sobstyl

doi:10.1055/s-0041-1739227

Journal of Neurological Surgery Part A: Central European Neurosurgery, Table of Contents

J Neurol Surg A Cent Eur Neurosurg 2022; 83(03): 275-282
DOI: 10.1055/s-0041-1739227

Review Article

Subjective and Objective Quality-of-Life Assessment of Outcome Measures in Cervical Spine Surgery for Degenerative Changes

Marek Prokopienko

¹Department of Neurosurgery, Institute of Psychiatry and Neurology, Warszawa, Poland

,

Michał Sobstyl

¹Department of Neurosurgery, Institute of Psychiatry and Neurology, Warszawa, Poland

› Author Affiliations

Abstract

Cervical spine diskectomy is a commonly used procedure in degenerative disease of cervical spine surgery. However, it is difficult to assess the quality of life after this widely applied and variously modified procedure. This literature review presents cervical diskectomy results, according to various scales and measures in multidirectional surgical strategies. Using relevant databases, we tried to find the best treatment options for degenerative disk disease and the best method of quality-of-life assessment, searching for modalities that may influence the outcome.

Keywords

anterior cervical diskectomy - adjacent segment disease - health-related quality of life (HRQoL)

Full Text

References

References
1 Robinson RA, Smith GW. Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Bull Johns Hopkins Hosp 1955; 96: 223-224
2 Cloward RB. The anterior approach for removal of ruptured cervical disks. 1958. J Neurosurg Spine 2007; 6 (05) 496-511
3 Kalsi-Ryan S, Singh A, Massicotte EM. et al. Ancillary outcome measures for assessment of individuals with cervical spondylotic myelopathy. Spine 2013; 38 (22, Suppl 1): S111-S122
4 Fairbank JCT, Pynsent PB. The Oswestry Disability Index. Spine 2000; 25 (22) 2940-2952 , discussion 2952
5 Fairbank JCT, Couper J, Davies JB, O'Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy 1980; 66 (08) 271-273
6 Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther 1991; 14 (07) 409-415
7 Cleland JA, Fritz JM, Whitman JM, Palmer JA. The reliability and construct validity of the Neck Disability Index and patient specific functional scale in patients with cervical radiculopathy. Spine 2006; 31 (05) 598-602
8 Hains F, Waalen J, Mior S. Psychometric properties of the neck disability index. J Manipulative Physiol Ther 1998; 21 (02) 75-80
9 McCarthy MJ, Grevitt MP, Silcocks P, Hobbs G. The reliability of the Vernon and Mior neck disability index, and its validity compared with the short form-36 health survey questionnaire. Eur Spine J 2007; 16 (12) 2111-2117
10 Bartels RH, Verbeek AL, Benzel EC, Fehlings MG, Guiot BH. Validation of a translated version of the modified Japanese orthopaedic association score to assess outcomes in cervical spondylotic myelopathy: an approach to globalize outcomes assessment tools. Neurosurgery 2010; 66 (05) 1013-1016
11 Bunevicius A. Reliability and validity of the SF-36 Health Survey Questionnaire in patients with brain tumors: a cross-sectional study. Health Qual Life Outcomes 2017; 15 (01) 92
12 McHorney CA, Ware Jr JE, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994; 32 (01) 40-66
13 Guilfoyle MR, Seeley H, Laing RJ. The Short Form 36 health survey in spine disease: validation against condition-specific measures. Br J Neurosurg 2009; 23 (04) 401-405
14 Kapetanakis S, Thomaidis T, Charitoudis G, Pavlidis P, Theodosiadis P, Gkasdaris G. Single anterior cervical discectomy and fusion (ACDF) using self- locking stand-alone polyetheretherketone (PEEK) cage: evaluation of pain and health-related quality of life. J Spine Surg 2017; 3 (03) 312-322
15 Godil SS, Parker SL, Zuckerman SL, Mendenhall SK, McGirt MJ. Accurately measuring the quality and effectiveness of cervical spine surgery in registry efforts: determining the most valid and responsive instruments. Spine J 2015; 15 (06) 1203-1209
16 Sundseth J, Kolstad F, Johnsen LG. et al. The Neck Disability Index (NDI) and its correlation with quality of life and mental health measures among patients with single-level cervical disc disease scheduled for surgery. Acta Neurochir (Wien) 2015; 157 (10) 1807-1812
17 Ko S, Choi W, Chae S, Kwon J, Lee Y. Correlation between Short-Form 36 Scores and Neck Disability Index in patients undergoing anterior cervical discectomy and fusion. Asian Spine J 2018; 12 (04) 691-696
18 Cook C, Richardson JK, Braga L. et al. Cross-cultural adaptation and validation of the Brazilian Portuguese version of the Neck Disability Index and Neck Pain and Disability Scale. Spine 2006; 31 (14) 1621-1627
19 Song KJ, Choi BW, Choi BR, Seo GB. Cross-cultural adaptation and validation of the Korean version of the neck disability index. Spine 2010; 35 (20) E1045-E1049
20 Schroeder GD, Boody BS, Kepler CK. et al. comparing health-related quality of life outcomes in patients undergoing either primary or revision anterior cervical discectomy and fusion. Spine 2018; 43 (13) E752-E757
21 Kopjar B, Tetreault L, Kalsi-Ryan S, Fehlings M. Psychometric properties of the modified Japanese Orthopaedic Association scale in patients with cervical spondylotic myelopathy. Spine 2015; 40 (01) E23-E28
22 Boody BS, Bhatt S, Mazmudar AS, Hsu WK, Rothrock NE, Patel AA. Validation of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests in cervical spine surgery. J Neurosurg Spine 2018; 28 (03) 268-279
23 Khan I, Pennings JS, Davidson C. et al. PROMIS-29 validity and conversion equation to Neck Disability Index (NDI) using a national sample of cervical spine surgery patients. Neurosurgery 2019; 66 (01) 310-331
24 Jansson KA, Németh G, Granath F, Jönsson B, Blomqvist P. Health-related quality of life (EQ-5D) before and one year after surgery for lumbar spinal stenosis. J Bone Joint Surg Br 2009; 91 (02) 210-216
25 Brooks R. EuroQol: the current state of play. Health Policy 1996; 37 (01) 53-72
26 Liow MHL, Lee M, Goh GS. et al. Poorer fusion outcomes in diabetic cervical spondylotic myelopathy patients undergoing single-level anterior cervical discectomy and fusion does not compromise functional outcomes and quality of life. Spine 2018; 43 (07) 477-483
27 Omidi-Kashani F, Ghayem Hasankhani E, Ghandehari R. Impact of age and duration of symptoms on surgical outcome of single-level microscopic anterior cervical discectomy and fusion in the patients with cervical spondylotic radiculopathy. Neurosci J 2014; 2014: 808596
28 Gaetani P, Tancioni F, Spanu G, Rodriguez y Baena R. Anterior cervical discectomy: an analysis on clinical long-term results in 153 cases. J Neurosurg Sci 1995; 39 (04) 211-218
29 Dimitriou R, Mataliotakis GI, Angoules AG, Kanakaris NK, Giannoudis PV. Complications following autologous bone graft harvesting from the iliac crest and using the RIA: a systematic review. Injury 2011; 42 (Suppl. 02) S3-S15
30 Troyanovich SJ, Stroink AR, Kattner KA, Dornan WA, Gubina I. Does anterior plating maintain cervical lordosis versus conventional fusion techniques? A retrospective analysis of patients receiving single-level fusions. J Spinal Disord Tech 2002; 15 (01) 69-74
31 Wang JC, McDonough PW, Endow K, Kanim LE, Delamarter RB. The effect of cervical plating on single-level anterior cervical discectomy and fusion. J Spinal Disord 1999; 12 (06) 467-471
32 Wilkinson JS, Mann SA, Stoneham GW, Hentschel S, Fourney DR. Comparison of post-operative lordosis with the PEEK cage and the cervical plate. Can J Neurol Sci 2011; 38 (01) 72-77
33 Sarkar S, Mazumder U, Chowdhury D. et al. Anterior cervical discectomy and fusion without instrumentation for cervical spondylosis. Mymensingh Med J 2012; 21 (03) 416-422
34 Samartzis D, Shen FH, Lyon C, Phillips M, Goldberg EJ, An HS. Does rigid instrumentation increase the fusion rate in one-level anterior cervical discectomy and fusion?. Spine J 2004; 4 (06) 636-643
35 Burneikiene S, Nelson EL, Mason A, Rajpal S, Villavicencio AT. The duration of symptoms and clinical outcomes in patients undergoing anterior cervical discectomy and fusion for degenerative disc disease and radiculopathy. Spine J 2015; 15 (03) 427-432
36 Lipetz JS. Pathophysiology of inflammatory, degenerative, and compressive radiculopathies. Phys Med Rehabil Clin N Am 2002; 13 (03) 439-449
37 Eriksen EF, Buhl M, Fode K. et al. Treatment of cervical disc disease using Cloward's technique. The prognostic value of clinical preoperative data in 1,106 patients. Acta Neurochir (Wien) 1984; 70 (3–4): 181-197
38 Hamburger C, Festenberg FV, Uhl E. Ventral discectomy with pmma interbody fusion for cervical disc disease: long-term results in 249 patients. Spine 2001; 26 (03) 249-255
39 Buttermann GR. Anterior cervical discectomy and fusion outcomes over 10 years: a prospective study. Spine 2018; 43 (03) 207-214
40 Spurling RG, Scoville WB. Lateral rupture of the cervical intervertebral discs. A common cause of shoulder and arm pain. Surg Gynecol Obstet 1944; 78: 350-358
41 Scoville WB, Dohrmann GJ, Corkill G. Late results of cervical disc surgery. J Neurosurg 1976; 45 (02) 203-210
42 Dohrmann GJ, Hsieh JC. Long-term results of anterior versus posterior operations for herniated cervical discs: analysis of 6,000 patients. Med Princ Pract 2014; 23 (01) 70-73
43 Jagannathan J, Sherman JH, Szabo T, Shaffrey CI, Jane JA. The posterior cervical foraminotomy in the treatment of cervical disc/osteophyte disease: a single-surgeon experience with a minimum of 5 years' clinical and radiographic follow-up. J Neurosurg Spine 2009; 10 (04) 347-356
44 McAnany SJ, Kim JS, Overley SC, Baird EO, Anderson PA, Qureshi SA. A meta-analysis of cervical foraminotomy: open versus minimally-invasive techniques. Spine J 2015; 15 (05) 849-856
45 Liu WJ, Hu L, Chou PH, Wang JW, Kan WS. Comparison of anterior cervical discectomy and fusion versus posterior cervical foraminotomy in the treatment of cervical radiculopathy: a systematic review. Orthop Surg 2016; 8 (04) 425-431
46 Fang W, Huang L, Feng F. et al. Anterior cervical discectomy and fusion versus posterior cervical foraminotomy for the treatment of single-level unilateral cervical radiculopathy: a meta-analysis. J Orthop Surg Res 2020; 15 (01) 202
47 Galbraith JG, Butler JS, Dolan AM, O'Byrne JM. Operative outcomes for cervical myelopathy and radiculopathy. Adv Orthoped 2012;919153
48 Wada E, Suzuki S, Kanazawa A, Matsuoka T, Miyamoto S, Yonenobu K. Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy: a long-term follow-up study over 10 years. Spine 2001; 26 (13) 1443-1447 , discussion 1448
49 Saunders RL, Pikus HJ, Ball P. Four-level cervical corpectomy. Spine 1998; 23 (22) 2455-2461
50 Kato Y, Iwasaki M, Fuji T, Yonenobu K, Ochi T. Long-term follow-up results of laminectomy for cervical myelopathy caused by ossification of the posterior longitudinal ligament. J Neurosurg 1998; 89 (02) 217-223
51 George B, Gauthier N, Lot G. Multisegmental cervical spondylotic myelopathy and radiculopathy treated by multilevel oblique corpectomies without fusion. Neurosurgery 1999; 44 (01) 81-90
52 Kimura H, Shikata J, Odate S, Soeda T. Anterior corpectomy and fusion to C2 for cervical myelopathy: clinical results and complications. Eur Spine J 2014; 23 (07) 1491-1501
53 Williams KE, Paul R, Dewan Y. Functional outcome of corpectomy in cervical spondylotic myelopathy. Indian J Orthop 2009; 43 (02) 205-209
54 Tykocki T, Poniatowski ŁA, Czyz M, Wynne-Jones G. Oblique corpectomy in the cervical spine. Spinal Cord 2018; 56 (05) 426-435
55 Ishihara H, Kanamori M, Kawaguchi Y, Nakamura H, Kimura T. Adjacent segment disease after anterior cervical interbody fusion. Spine J 2004; 4 (06) 624-628
56 Katsuura A, Hukuda S, Saruhashi Y, Mori K. Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent intervertebral levels. Eur Spine J 2001; 10 (04) 320-324
57 Kienapfel H, Koller M, Hinder D. et al. Integrated outcome assessment after anterior cervical discectomy and fusion: myelocompression but not adjacent instability affect patient-reported quality of life and cervical spine symptoms. Spine 2004; 29 (22) 2501-2509
58 Wu W, Thuomas KA, Hedlund R, Leszniewski W, Vavruch L. Fast spin-echo MR assessment of patients with poor outcome following spinal cervical surgery. Acta Radiol 1996; 37 (02) 153-161
59 Ahn SS, Paik HK, Chin DK, Kim SH, Kim DW, Ku MG. The fate of adjacent segments after anterior cervical discectomy and fusion: the influence of an anterior plate system. World Neurosurg 2016; 89: 42-50
60 Ji GY, Oh CH, Shin DA, Ha Y, Kim KN, Yoon DH. Fast spin-echo MR assessment of patients with poor outcome following spinal cervical surgery segment degeneration. J Spinal Disord 2015; 28: E433-E438
61 Song KJ, Choi BW, Kim JK. Adjacent segment pathology following anterior decompression and fusion using cage and plate for the treatment of degenerative cervical spinal diseases. Asian Spine J 2014; 8 (06) 720-728
62 Viswanathan VK, Manoharan SR. To plate or not to plate after a single- or two-level anterior cervical discectomy: fusion with cage-plate construct or stand-alone cage. Asian Spine J 2017; 11 (01) 1-3
63 Cheung ZB, Gidumal S, White S. et al. Comparison of anterior cervical discectomy and fusion with a stand-alone interbody cage versus a conventional cage-plate technique: a systematic review and meta-analysis. Global Spine J 2019; 9 (04) 446-455
64 Nambiar M, Phan K, Cunningham JE, Yang Y, Turner PL, Mobbs R. Locking stand-alone cages versus anterior plate constructs in single-level fusion for degenerative cervical disease: a systematic review and meta-analysis. Eur Spine J 2017; 26 (09) 2258-2266
65 Chen Y, Lü G, Wang B, Li L, Kuang L. A comparison of anterior cervical discectomy and fusion (ACDF) using self-locking stand-alone polyetheretherketone (PEEK) cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy: a retrospective study with 2-year follow-up. Eur Spine J 2016; 25 (07) 2255-2262
66 Wang Z, Jiang W, Zhang Z. et al. Comparison of ROI-C and traditional cage with anterior plating for anterior cervical discectomy and fusion. Zhonghua Wai Ke Za Zhi 2014; 52 (06) 425-430
67 Burkhardt BW, Brielmaier M, Schwerdtfeger K, Oertel JM. Clinical outcome following anterior cervical discectomy and fusion with and without anterior cervical plating for the treatment of cervical disc herniation-a 25-year follow-up study. Neurosurg Rev 2018; 41 (02) 473-482
68 Chung JY, Kim SK, Jung ST, Lee KB. Clinical adjacent-segment pathology after anterior cervical discectomy and fusion: results after a minimum of 10-year follow-up. Spine J 2014; 14 (10) 2290-2298
69 Louie PK, Presciutti SM, Iantorno SE. et al. There is no increased risk of adjacent segment disease at the cervicothoracic junction following an anterior cervical discectomy and fusion to C7. Spine J 2017; 17 (09) 1264-1271
70 Shriver MF, Lewis DJ, Kshettry VR, Rosenbaum BP, Benzel EC, Mroz TE. Pseudoarthrosis rates in anterior cervical discectomy and fusion: a meta-analysis. Spine J 2015; 15 (09) 2016-2027
71 Hilibrand AS, Robbins M. Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion?. Spine J 2004; 4 (6, Suppl) 190S-194S
72 Wigfield C, Gill S, Nelson R, Langdon I, Metcalf N, Robertson J. Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg 2002; 96 (1, Suppl): 17-21
73 Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 1999; 81 (04) 519-528
74 Hu Y, Lv G, Ren S, Johansen D. Mid- to long-term outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion for treatment of symptomatic cervical disc disease: a systematic review and meta-analysis of eight prospective randomized controlled trials. PLoS One 2016; 11 (02) e0149312
75 Cheng L, Nie L, Li M, Huo Y, Pan X. Superiority of the Bryan(®) disc prosthesis for cervical myelopathy: a randomized study with 3-year followup. Clin Orthop Relat Res 2011; 469 (12) 3408-3414
76 Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA. Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine 2007; 6 (03) 198-209
77 Coric D, Nunley PD, Guyer RD. et al. Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex|C artificial disc investigational device exemption study with a minimum 2-year follow-up: clinical article. J Neurosurg Spine 2011; 15 (04) 348-358
78 Delamarter RB, Zigler J. Five-year reoperation rates, cervical total disc replacement versus fusion, results of a prospective randomized clinical trial. Spine 2013; 38 (09) 711-717
79 Hisey MS, Bae HW, Davis R. et al. Multi-center, prospective, randomized, controlled investigational device exemption clinical trial comparing Mobi-C Cervical Artificial Disc to anterior discectomy and fusion in the treatment of symptomatic degenerative disc disease in the cervical spine. Int J Spine Surg 2014; 8: 7
80 Davis RJ, Kim KD, Hisey MS. et al. Cervical total disc replacement with the Mobi-C cervical artificial disc compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled multicenter clinical trial: clinical article. J Neurosurg Spine 2013; 19 (05) 532-545
81 Luo J, Gong M, Huang S, Yu T, Zou X. Incidence of adjacent segment degeneration in cervical disc arthroplasty versus anterior cervical decompression and fusion meta-analysis of prospective studies. Arch Orthop Trauma Surg 2015; 135 (02) 155-160
82 Maldonado CV, Paz RD, Martin CB. Adjacent-level degeneration after cervical disc arthroplasty versus fusion. Eur Spine J 2011; 20 (Suppl. 03) 403-407
83 Karabag H, Cakmak E, Celik B, Iplikcioglu AC, Soran AF. Arthroplasty versus fusion for single-level cervical disc disease. J Pak Med Assoc 2014; 64 (12) 1348-1351
84 Jawahar A, Cavanaugh DA, Kerr III EJ, Birdsong EM, Nunley PD. Total disc arthroplasty does not affect the incidence of adjacent segment degeneration in cervical spine: results of 93 patients in three prospective randomized clinical trials. Spine J 2010; 10 (12) 1043-1048
85 Nabhan A, Ishak B, Steudel WI, Ramadhan S, Steimer O. Assessment of adjacent-segment mobility after cervical disc replacement versus fusion: RCT with 1 year's results. Eur Spine J 2011; 20 (06) 934-941
86 Verma K, Gandhi SD, Maltenfort M. et al. Rate of adjacent segment disease in cervical disc arthroplasty versus single-level fusion: meta-analysis of prospective studies. Spine 2013; 38 (26) 2253-2257
87 DiAngelo DJ, Roberston JT, Metcalf NH, McVay BJ, Davis RC. Biomechanical testing of an artificial cervical joint and an anterior cervical plate. J Spinal Disord Tech 2003; 16 (04) 314-323
88 Dmitriev AE, Cunningham BW, Hu N, Sell G, Vigna F, McAfee PC. Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: an in vitro human cadaveric model. Spine 2005; 30 (10) 1165-1172
89 Gandhi AA, Kode S, DeVries NA, Grosland NM, Smucker JD, Fredericks DC. Biomechanical analysis of cervical disc replacement and fusion using single level, two level, and hybrid constructs. Spine 2015; 40 (20) 1578-1585
90 Lee JH, Kim JS, Lee JH, Chung ER, Shim CS, Lee SH. Comparison of cervical kinematics between patients with cervical artificial disc replacement and anterior cervical discectomy and fusion for cervical disc herniation. Spine J 2014; 14 (07) 1199-1204
91 Radcliff K, Coric D, Albert T. Five-year clinical results of cervical total disc replacement compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled, multicenter investigational device exemption clinical trial. J Neurosurg Spine 2016; 25 (02) 213-224
92 Meisel HJ, Jurák L, Antinheimo J. et al. Four-year results of a prospective single-arm study on 200 semi-constrained total cervical disc prostheses: clinical and radiographic outcome. J Neurosurg Spine 2016; 25 (05) 556-565
93 Mehren C, Heider F, Siepe CJ. et al. Clinical and radiological outcome at 10 years of follow-up after total cervical disc replacement. Eur Spine J 2017; 26 (09) 2441-2449
94 Nandyala SV, Marquez-Lara A, Fineberg SJ, Singh K. Comparison of revision surgeries for one- to two-level cervical TDR and ACDF from 2002 to 2011. Spine J 2014; 14 (12) 2841-2846
95 Anderson PA, Sasso RC, Riew KD. Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis. Spine 2008; 33 (12) 1305-1312
96 Zhang HX, Shao YD, Chen Y. et al. A prospective, randomised, controlled multicentre study comparing cervical disc replacement with anterior cervical decompression and fusion. Int Orthop 2014; 38 (12) 2533-2541
97 Zou S, Gao J, Xu B, Lu X, Han Y, Meng H. Anterior cervical discectomy and fusion (ACDF) versus cervical disc arthroplasty (CDA) for two contiguous levels cervical disc degenerative disease: a meta-analysis of randomized controlled trials. Eur Spine J 2017; 26 (04) 985-997
98 Sasso RC, Anderson PA, Riew KD, Heller JG. Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial. J Bone Joint Surg Am 2011; 93 (18) 1684-1692
99 Phillips FM, Tzermiadianos MN, Voronov LI. et al. Effect of two-level total disc replacement on cervical spine kinematics. Spine 2009; 34 (22) E794-E799
100 Hacker FM, Babcock RM, Hacker RJ. Very late complications of cervical arthroplasty: results of 2 controlled randomized prospective studies from a single investigator site. Spine 2013; 38 (26) 2223-2226
101 Griffin WL, Fehring TK, Pomeroy DL, Gruen TA, Murphy JA. Sterilization and wear-related failure in first- and second-generation press-fit condylar total knee arthroplasty. Clin Orthop Relat Res 2007; 464 (464) 16-20
102 Kurtz SM, van Ooij A, Ross R. et al. Polyethylene wear and rim fracture in total disc arthroplasty. Spine J 2007; 7 (01) 12-21
103 Moatz B, Tortolani PJ. Cervical disc arthroplasty: pros and cons. Surg Neurol Int 2012; 3 (Suppl. 03) S216-S224
104 Chen J, Wang X, Bai W, Shen X, Yuan W. Prevalence of heterotopic ossification after cervical total disc arthroplasty: a meta-analysis. Eur Spine J 2012; 21 (04) 674-680
105 Xu JX, Zhang YZ, Shen Y, Ding WY. Effect of modified techniques in Bryan cervical disc arthroplasty. Spine 2009; 34 (10) 1012-1017
106 Zhang X, Zhang X, Chen C. et al. Randomized, controlled, multicenter, clinical trial comparing BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion in China. Spine 2012; 37 (06) 433-438
107 Goffin J, Van Calenbergh F, van Loon J. et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level. Spine 2003; 28 (24) 2673-2678