Is artificial disc replacement better than fusion for patients with radiculopathy?
A new study published in The Spine Journal compares results for patients who underwent artificial disc replacement and traditional fusions for cervical radiculopathy. The study wasn't an investigational device exemption study and was partially funded with unrestricted grants by a company marketing an artificial disc.
The study was a multi-center endeavor that included 153 patients. The patients were either treated with the DePuy Discover artificial disc or with iliac crest bone graft and plating. There was data available for 137 patients and the researchers found:
1. Both the disc replacement and fusion groups reported significant improvement after surgery.
2. The NDI self assessment changed from 63.1 to 39.8 in an intention-to-treat analysis.
3. There weren't any differences between the two groups with the NDI values reaching 39.1 for disc replacement and 40.1 for spinal fusion.
4. There weren't any significant differences in the EQ-5D and VAS scores between the two groups.
5. There were nine patients in the disc replacement group who underwent a secondary surgery procedure; three patients in the fusion group underwent a secondary procedure.
6. Complication rates were similar between the two groups
"Artificial disc replacement did not result in better outcome compared to fusion measured with Neck Disability Index two years after surgery," reported the study authors.