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Author Notes:

Address for correspondence and reprint requests John Rhee, MDjmrhee@emory.edu

We thank Mike Fawcett for his assistance in putting the survey online, merging demographic data and other logistics; Devon Brewer, Dan Riew, and Dan Norvell for critique of survey design and content.

The authors have no competing or financial interests to disclose in relation to this work.


Cervical artificial disc replacement (C-ADR): global perspectives on use and trends


Journal Title:

Evidence-Based Spine-Care Journal


Volume 3, Number S1


, Pages 53-58

Type of Work:

Article | Post-print: After Peer Review


Study design: Cross-sectional survey. Objectives: To obtain information from the global community regarding cervical artificial disc replacement (C-ADR) use and trends before and after US Food and Drug Administration (FDA) approval of devices in 2007 and summarize available information on utilization and government approval for devices. Methods: Data on utilization and approval were sought from PubMed, Google, FDA, and manufacturers’ websites. The 6195 members of AOSpine International were invited to participate in a survey to assess global C-ADR use and trends. Results: Publically available data on utilization, trends, and approval outside of the US and Europe is limited. No studies of utilization were found. Of 1479 professionals responding to the survey, 50% had C-ADR specific training and reported ever performing C-ADR. Most respondents believed that C-ADR was safe and effective, but approximately one quarter responded that they did not know. Of those who had done C-ADR, 49% reported performing ≥ 1 before December compared with 92% after January 2008 and 51.3% indicated that all their C-ADRs were placed in a single level; 27% reported ≥ 1 failures that required revision. The majority foresee that C-ADR use will increase in the next 5 years. Most respondents believed that the best indication is radiculopathy from soft-disc pathology rather than myelopathy or disorders arising from spondylotic (hard-disc) pathology. Conclusion: More C-ADR has been performed after January 2008. Most respondents expect the number to increase. There may be differences in failure rates when performed inside or outside of a sponsored research trial.

Copyright information:

© Thieme Medical Publishers

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