Objective: To evaluate the clinical outcomes of multi-level cervical Bryan disc replacement.
Method: Twenty patients with diseases of cervical vertebrae underwent multi-level cervical Bryan disc replacements, 18 patients undergoing double-level displacement and 2 undergoing triple-level displacement. Roentgenography was used to examine the movement of replacement segment, height of movement segment, and movement of the adjacent-segments. Japanese Orthopaedic Association (JOA) score, neck disability index (NDI) score, and Odom's standards were evaluated.
Result: The average movement of the replaced segment could be preserved to 86.2% that of the original degree, the overall movement of cervical could be preserved to 87.3% that of the original degree l. The post-operative JOA score was 16.1 1.6, p significantly higher than that before operation (12.7 +/- 3.0, P < 0.05) with an improvement rate was very good in 80.1%. The follow-up NDI score was 8.6 +/- 7.5. According to the Odom's standards, the outcome was very good in 50% of the patient, good in 40%, and OK in 10%. The radiographic measurements showed no significant difference in the cervical curve between the pre-operative and post-operative values.
Conclusion: An encouraging option for anterior cervical fusion, multi-level cervical Bryan disc replacement can not only preserve the cervical physiological movement and curve, but also decrease the degeneration of adjacent-segment.