Implantable Cervical Disc Offers Extended Range of Motion

A new artificial disc permits rehabilitation of cervical motion following single-level discectomy for intractable radiculopathy and myelopathy.

The BRYAN Cervical Disc is a titanium-polyurethane prosthetic device that is inserted between the vertebrae--placed in milled pockets in the adjacent vertebral bodies--to replace the natural spinal disc in levels C3-C7; the disc is implanted via an open anterior approach. The disc consists of two main metal sections separated by a polyurethane middle section, and is designed to maintain range of motion in the neck. The central polyurethane section allows motion of the cervical spine, including flexion and extension (forward-backward rotation), lateral bending (side-to-side rotation), axial rotation (looking left and right), as well as translation (gliding motion). The BRYAN system is a potential alternative to current standard anterior cervical discectomy and fusion (ACDF). With ACDF, the diseased disc is removed and the resulting cavity is fused using a bone graft attached with a plate and bone screws, a process that eliminates the range of motion in the operated segment of the neck. The BRYAN Cervical Disc is a product of Medtronic (Minneapolis, MN, USA), and has been approved by the U.S. Food and Drug Administration (FDA).


"The results from the U.S. clinical study demonstrate that cervical arthroplasty with the BRYAN Cervical Disc is a viable alternative to cervical fusion in appropriately indicated patients,” said John Heller, M.D., a spine surgeon and professor of orthopedic surgery at Emory University (Atlanta, GA, USA). "At the 2-year follow-up in the study, BRYAN Cervical Disc patients had statistically superior outcomes in overall success and neck disability index success compared to ACDF patients.”

Radiculopathy is not a specific condition, but rather a description of a problem in which one or more nerves are affected and do not work properly. The emphasis is on the nerve root; this can result in pain, weakness, numbness, or difficulty in controlling specific muscles. Myelopathy, on the other hand, refers to a pathology of the spinal cord. When due to trauma, it is known as spinal cord injury. When inflammatory, it is known as myelitis. When the disease is vascular in nature, it is known as vascular myelopathy.

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