(HealthDay)—Total disc replacement (TDR) is associated with a lower reoperation rate and longer time to reoperation compared with anterior cervical fusion (ACF), according to a study published in the June 15 issue of Spine.
Scott L. Blumenthal, M.D., from the Texas Back Institute in Plano, and colleagues analyzed prospectively collected data from 136 patients (84 TDR, 52 ACF) enrolled in one of six single-site U.S. Food and Drug Administration regulated investigational device exemption trials. TDR and ACF groups were compared with regard to reoperation rates and the length of time to reoperation.
During a mean follow-up of 55.1 months, the researchers found that the rate of reoperation was significantly less in the TDR group (8.3 percent) compared with the ACF group (21.2 percent). The rate of reoperation attributed to adjacent segment degeneration was less in the TDR group than in the ACF group, with a trend toward significance (4.8 versus 13.5 percent; 0.05 < P < 0.07). Four patients in the ACF group (7.7 percent) underwent reoperation for pseudoarthrosis. When comparing the mean number of months between index and subsequent procedures, the TDR group had reoperations significantly later than the fusion group (P < 0.01). Furthermore, by Kaplan-Meier survival analysis, the TDR group had a significantly longer survival period before undergoing reoperation.
"This study found the reoperation rate was significantly less in the TDR group compared with ACF group and that the survival time to reoperation was greater in the TDR group," the authors write.
The authors disclosed financial ties to industry.
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