{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:23:03Z","timestamp":1794324183099,"version":"4.9.0"},"reference-count":54,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Anterior cervical discectomy and fusion had been considered a safe and effective procedure for radiculopathy and myelopathy in the cervical spine, but degeneration in adjacent spinal levels has been a problem in some patients after fusion. Since 2002, cervical disc arthroplasty has been established as an alternative to fusion. The objective of this study was to review data concerning the role of cervical arthroplasty in reducing adjacent-level degeneration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was performed using the MEDLINE, EMBASE, Cochrane, and LILACS databases, focusing on a structured question involving the population of interest, types of intervention, types of control, and outcomes studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No study has specifically compared the results of arthroplasty with the results of fusion with respect to the rate of postoperative development of adjacent-segment degenerative disease. One paper described a rate for adjacent-level surgery. The level of evidence of that paper was classified 2b, and although its authors found a statistically significant between-groups difference (arthroplasty vs fusion) using log-rank analysis, re-analysis according to number needed to treat (in the current paper) did not reveal statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adjacent-level degeneration has not been adequately studied in a review of the available randomized controlled trials on this topic, and there is no clinical evidence of reduction in adjacent-level degeneration with the use of cervical arthroplasty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2010.3.focus1032","type":"journal-article","created":{"date-parts":[[2011,2,23]],"date-time":"2011-02-23T11:43:05Z","timestamp":1298461385000},"page":"E5","source":"Crossref","is-referenced-by-count":42,"title":["A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration"],"prefix":"10.3171","volume":"28","author":[{"given":"Ricardo Vieira","family":"Botelho","sequence":"first","affiliation":[{"name":"Neurosurgical Service, Hospital do Servidor P\u00fablico do Estado de S\u00e3o Paulo, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osmar Jos\u00e9 dos Santos","family":"Moraes","sequence":"additional","affiliation":[{"name":"Neurosurgical Service, Hospital Santa Marcelina; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo Alberto","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade Cidade de S\u00e3o Paulo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri dos Santos","family":"Buscariolli","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade Cidade de S\u00e3o Paulo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanderley Marques","family":"Bernardo","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Associa\u00e7\u00e3o Medica Brasileira, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2001","DOI":"10.1097\/BRS.0b013e3181b03fe6","article-title":"Sagittal cervical alignment after cervical disc arthroplasty and anterior cervical discectomy and fusion: results of a prospective, randomized, controlled trial","volume":"34","author":"Anakwenze","year":"2009"},{"key":"b2-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1097\/BRS.0b013e31817329a1","article-title":"Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis","volume":"33","author":"Anderson","year":"2008"},{"key":"b3-0280005","series-title":"Int Orthop","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1007\/s00264-008-0655-3","article-title":"Fusion versus Bryan Cervical Disc in two-level cervical disc disease: a prospective, randomised study","volume":"33","author":"Cheng","year":"2009"},{"key":"b4-0280005","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"31","DOI":"10.3171\/spi.2006.4.1.31","article-title":"Prospective randomized controlled study of the Bryan Cervical Disc: early clinical results from a single investigational site","volume":"4","author":"Coric","year":"2006"},{"key":"b5-0280005","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1097\/00006123-200209000-00048","article-title":"Preliminary clinical experience with the Bryan Cervical Disc prosthesis","volume":"51","author":"Goffin","year":"2002"},{"key":"b6-0280005","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"424","DOI":"10.3171\/spi.2005.3.6.0424","article-title":"Cervical disc arthroplasty: a controlled randomized prospective study with intermediate follow-up results. Invited submission from the joint section meeting on disorders of the spine and peripheral nerves, March 2005","volume":"3","author":"Hacker","year":"2005"},{"key":"b7-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1097\/BRS.0b013e31818ee263","article-title":"Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial","volume":"34","author":"Heller","year":"2009"},{"issue":"6 Suppl","key":"b8-0280005","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"190S","DOI":"10.1016\/j.spinee.2004.07.007","article-title":"Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion?","volume":"4","author":"Hilibrand","year":"2004"},{"key":"b9-0280005","series-title":"Control Clin Trials","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/0197-2456(95)00134-4","article-title":"Assessing the quality of reports of randomized clinical trials: is blinding necessary?","volume":"17","author":"Jadad","year":"1996"},{"issue":"6","key":"b10-0280005","series-title":"Neurosurg Focus","first-page":"E14","article-title":"Sagittal alignment and the Bryan cervical artificial disc","volume":"17","author":"Johnson","year":"2004"},{"key":"b11-0280005","series-title":"Comput Inform Nurs","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1097\/NCN.0b013e31818dd3d7","article-title":"A description of a web-based educational tool for understanding the PICO framework in evidence-based practice with a citation ranking system","volume":"27","author":"LaRue","year":"2009"},{"key":"b12-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1097\/BRS.0b013e3181aa643b","article-title":"Stress analysis of the interface between cervical vertebrae end plates and the Bryan, Prestige LP, and ProDisc-C cervical disc prostheses: an in vivo image-based finite element study","volume":"34","author":"Lin","year":"2009"},{"key":"b13-0280005","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1016\/S0140-6736(00)04337-3","article-title":"The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials","volume":"357","author":"Moher","year":"2001"},{"key":"b14-0280005","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"198","DOI":"10.3171\/spi.2007.6.3.198","article-title":"Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial","volume":"6","author":"Mummaneni","year":"2007"},{"key":"b15-0280005","series-title":"Spine J","first-page":"275","article-title":"Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease","volume":"9","author":"Murrey","year":"2009"},{"key":"b16-0280005","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1007\/s00586-006-0226-5","article-title":"Disc replacement using Pro-Disc C versus fusion: a prospective randomised and controlled radiographic and clinical study","volume":"16","author":"Nabhan","year":"2007"},{"key":"b17-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1935","DOI":"10.1097\/BRS.0b013e31813162d8","article-title":"The ProDisc-C prosthesis: clinical and radiological experience 1 year after surgery","volume":"32","author":"Nabhan","year":"2007"},{"issue":"3","key":"b18-0280005","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Clinical outcomes with the Prestige II cervical disc: preliminary results from a prospective randomized clinical trial","volume":"17","author":"Porchet","year":"2004"},{"key":"b19-0280005","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"2354","DOI":"10.2106\/JBJS.G.01608","article-title":"Cervical disc arthroplasty compared with arthrodesis for the treatment of myelopathy","volume":"90","author":"Riew","year":"2008"},{"key":"b20-0280005","series-title":"Am J Orthop","first-page":"E71","article-title":"Comparison of single-level cervical fusion and a metal-on-metal cervical disc replacement device","volume":"37","author":"Riina","year":"2008"},{"key":"b21-0280005","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/BSD.0b013e3180500778","article-title":"Cervical kinematics after fusion and Bryan disc arthroplasty","volume":"21","author":"Sasso","year":"2008"},{"key":"b22-0280005","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1097\/BSD.0b013e318150d121","article-title":"Motion analysis of Bryan cervical disc arthroplasty versus anterior discectomy and fusion: results from a prospective, randomized, multicenter, clinical trial","volume":"21","author":"Sasso","year":"2008"},{"key":"b23-0280005","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1097\/BSD.0b013e3180310534","article-title":"Clinical outcomes of BRYAN cervical disc arthroplasty: a prospective, randomized, controlled, multicenter trial with 24-month follow-up","volume":"20","author":"Sasso","year":"2007"},{"key":"b24-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1097\/01.brs.0000257547.17822.14","article-title":"Magnetic resonance imaging clarity of the Bryan, Prodisc-C, Prestige LP, and PCM cervical arthroplasty devices","volume":"32","author":"Sekhon","year":"2007"},{"key":"b25-0280005","series-title":"Pain","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1016\/j.pain.2008.06.025","article-title":"Analyzing multiple endpoints in clinical trials of pain treatments: IMMPACT recommendations. Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials","volume":"139","author":"Turk","year":"2008"},{"key":"b26-0280005","series-title":"Zhonghua Wai Ke Za Zhi","first-page":"328","article-title":"[Clinical outcomes of single level Bryan cervical disc arthroplasty: a prospective controlled study.]","volume":"46","author":"Wang","year":"2008"},{"key":"b27-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1097\/BRS.0b013e31819c4a5b","article-title":"Effect of modified techniques in Bryan cervical disc arthroplasty","volume":"34","author":"Xu","year":"2009"},{"key":"b1-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2001","DOI":"10.1097\/BRS.0b013e3181b03fe6","article-title":"Sagittal cervical alignment after cervical disc arthroplasty and anterior cervical discectomy and fusion: results of a prospective, randomized, controlled trial","volume":"34","author":"Anakwenze","year":"2009"},{"key":"b2-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1097\/BRS.0b013e31817329a1","article-title":"Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis","volume":"33","author":"Anderson","year":"2008"},{"key":"b3-0280005","series-title":"Int Orthop","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1007\/s00264-008-0655-3","article-title":"Fusion versus Bryan Cervical Disc in two-level cervical disc disease: a prospective, randomised study","volume":"33","author":"Cheng","year":"2009"},{"key":"b4-0280005","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"31","DOI":"10.3171\/spi.2006.4.1.31","article-title":"Prospective randomized controlled study of the Bryan Cervical Disc: early clinical results from a single investigational site","volume":"4","author":"Coric","year":"2006"},{"key":"b5-0280005","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1097\/00006123-200209000-00048","article-title":"Preliminary clinical experience with the Bryan Cervical Disc prosthesis","volume":"51","author":"Goffin","year":"2002"},{"key":"b6-0280005","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"424","DOI":"10.3171\/spi.2005.3.6.0424","article-title":"Cervical disc arthroplasty: a controlled randomized prospective study with intermediate follow-up results. Invited submission from the joint section meeting on disorders of the spine and peripheral nerves, March 2005","volume":"3","author":"Hacker","year":"2005"},{"key":"b7-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1097\/BRS.0b013e31818ee263","article-title":"Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial","volume":"34","author":"Heller","year":"2009"},{"issue":"6 Suppl","key":"b8-0280005","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"190S","DOI":"10.1016\/j.spinee.2004.07.007","article-title":"Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion?","volume":"4","author":"Hilibrand","year":"2004"},{"key":"b9-0280005","series-title":"Control Clin Trials","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/0197-2456(95)00134-4","article-title":"Assessing the quality of reports of randomized clinical trials: is blinding necessary?","volume":"17","author":"Jadad","year":"1996"},{"issue":"6","key":"b10-0280005","series-title":"Neurosurg Focus","first-page":"E14","article-title":"Sagittal alignment and the Bryan cervical artificial disc","volume":"17","author":"Johnson","year":"2004"},{"key":"b11-0280005","series-title":"Comput Inform Nurs","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1097\/NCN.0b013e31818dd3d7","article-title":"A description of a web-based educational tool for understanding the PICO framework in evidence-based practice with a citation ranking system","volume":"27","author":"LaRue","year":"2009"},{"key":"b12-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1097\/BRS.0b013e3181aa643b","article-title":"Stress analysis of the interface between cervical vertebrae end plates and the Bryan, Prestige LP, and ProDisc-C cervical disc prostheses: an in vivo image-based finite element study","volume":"34","author":"Lin","year":"2009"},{"key":"b13-0280005","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1016\/S0140-6736(00)04337-3","article-title":"The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials","volume":"357","author":"Moher","year":"2001"},{"key":"b14-0280005","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"198","DOI":"10.3171\/spi.2007.6.3.198","article-title":"Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial","volume":"6","author":"Mummaneni","year":"2007"},{"key":"b15-0280005","series-title":"Spine J","first-page":"275","article-title":"Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease","volume":"9","author":"Murrey","year":"2009"},{"key":"b16-0280005","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1007\/s00586-006-0226-5","article-title":"Disc replacement using Pro-Disc C versus fusion: a prospective randomised and controlled radiographic and clinical study","volume":"16","author":"Nabhan","year":"2007"},{"key":"b17-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1935","DOI":"10.1097\/BRS.0b013e31813162d8","article-title":"The ProDisc-C prosthesis: clinical and radiological experience 1 year after surgery","volume":"32","author":"Nabhan","year":"2007"},{"issue":"3","key":"b18-0280005","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Clinical outcomes with the Prestige II cervical disc: preliminary results from a prospective randomized clinical trial","volume":"17","author":"Porchet","year":"2004"},{"key":"b19-0280005","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"2354","DOI":"10.2106\/JBJS.G.01608","article-title":"Cervical disc arthroplasty compared with arthrodesis for the treatment of myelopathy","volume":"90","author":"Riew","year":"2008"},{"key":"b20-0280005","series-title":"Am J Orthop","first-page":"E71","article-title":"Comparison of single-level cervical fusion and a metal-on-metal cervical disc replacement device","volume":"37","author":"Riina","year":"2008"},{"key":"b21-0280005","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/BSD.0b013e3180500778","article-title":"Cervical kinematics after fusion and Bryan disc arthroplasty","volume":"21","author":"Sasso","year":"2008"},{"key":"b22-0280005","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1097\/BSD.0b013e318150d121","article-title":"Motion analysis of Bryan cervical disc arthroplasty versus anterior discectomy and fusion: results from a prospective, randomized, multicenter, clinical trial","volume":"21","author":"Sasso","year":"2008"},{"key":"b23-0280005","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1097\/BSD.0b013e3180310534","article-title":"Clinical outcomes of BRYAN cervical disc arthroplasty: a prospective, randomized, controlled, multicenter trial with 24-month follow-up","volume":"20","author":"Sasso","year":"2007"},{"key":"b24-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1097\/01.brs.0000257547.17822.14","article-title":"Magnetic resonance imaging clarity of the Bryan, Prodisc-C, Prestige LP, and PCM cervical arthroplasty devices","volume":"32","author":"Sekhon","year":"2007"},{"key":"b25-0280005","series-title":"Pain","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1016\/j.pain.2008.06.025","article-title":"Analyzing multiple endpoints in clinical trials of pain treatments: IMMPACT recommendations. Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials","volume":"139","author":"Turk","year":"2008"},{"key":"b26-0280005","series-title":"Zhonghua Wai Ke Za Zhi","first-page":"328","article-title":"[Clinical outcomes of single level Bryan cervical disc arthroplasty: a prospective controlled study.]","volume":"46","author":"Wang","year":"2008"},{"key":"b27-0280005","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1097\/BRS.0b013e31819c4a5b","article-title":"Effect of modified techniques in Bryan cervical disc arthroplasty","volume":"34","author":"Xu","year":"2009"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/28\/6\/2010.3.focus1032.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/28\/6\/2010.3.focus1032.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/28\/6\/2010.3.focus1032.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:16:23Z","timestamp":1780733783000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/28\/6\/2010.3.focus1032.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,6]]},"references-count":54,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2010.3.focus1032","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,6]]}}}