Cervical Alignment Analysis Comparing Two-Level Cervical Disc Arthroplasty with Anterior Cervical Discectomy and Fusion with Anterior Plate Fixation

Bakare, Adewale A.; Kolcun, John Paul G.; Piracha, Ali; Moss, Jonah R; Khanna, Raman; O’Toole, John E.; Deutsch, Harel; Traynelis, Vincent C.; Fessler, Richard G.

doi:10.1016/j.wneu.2022.06.109

Cited by 5 publications

(15 citation statements)

References 30 publications

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“…After exclud ing duplicates, the search yielded a total of 118 unique citations, for which titles and ab stracts were screened. A total of 16 full-text articles were assessed for eligibility, and 8 were excluded for not reporting outcomes of interest or having unsuitable comparisons Finally, eight studies (two RCTs, four retrospective studies, and two prospective studies were included in the systematic review and meta-analysis [23][24][25][26][27][28][29][30].…”

Section: Search Resultsmentioning

confidence: 99%

“…Among these, the CDA group had a lower complication rate (OR, 0.548, 95% CI: 0.326 to 0.919, p = 0.023, I 2 = 0%) than the ACDF group. Three studies reported secondary surgery rates [23,26,27]. Heterogeneity was not observed across the studies (Q statistic = 0.077, I 2 = 0%, p = 0.962).…”

Section: Meta-analysis Of Secondary Outcomesmentioning

confidence: 94%

“…A significantly higher overall success rate was observed in the CDA group compared to that in the ACDF group (OR, 2.710, 95% CI: 1.949 to 3.770) (Figure 2A). Six studies reported changes in neck pain VAS [23,25,[27][28][29][30]. Among these, a greater improvement in neck pain VAS was observed in the CDA group over the ACDF group (standardized mean difference: 0.236, 95% CI: 0.071 to 0.400, p = 0.005, I 2 = 4%).…”

Section: Characteristics Of Included Studies and Baseline Patient Dem...mentioning

confidence: 99%

“…Figure 2C-F show the results of the meta-analysis for changes from the baseline in the NDI, neck pain VAS, arm pain VAS, and JOA scores after CDA and ACDF.Six studies reported changes in neck pain VAS[23,25,[27][28][29][30]. Among these, a greater improvement in neck pain VAS was observed in the CDA group over the ACDF group (standardized mean difference: 0.236, 95% CI: 0.071 to 0.400, p = 0.005, I 2 = 4%).Seven studies reported NDI changes[23][24][25][27][28][29][30], four studies reported changes in arm pain VAS[23,24,27,28], and three studies reported changes in the JOA score[23,25,28]. The results of the meta-analyses showed no significant differences in changes in the NDI, arm pain VAS, and JOA scores between the two procedures (all p > 0.05).Figure2Gshows the meta-analysis results for complication rates between CDA and ACDF.…”

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Cervical Disc Arthroplasty (CDA) versus Anterior Cervical Discectomy and Fusion (ACDF) for Two-Level Cervical Disc Degenerative Disease: An Updated Systematic Review and Meta-Analysis

Chen,

Yang,

2024

JCM

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Background: Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are both considered to be efficacious surgical procedures for treating cervical spondylosis in patients with or without compression myelopathy. This updated systematic review and meta-analysis aimed to compare the outcomes of these procedures for the treatment of cervical degenerative disc disease (DDD) at two contiguous levels. Methods: The PubMed, EMBASE, and Cochrane CENTRAL databases were searched up to 1 May 2023. Studies comparing the outcomes between CDA and ACDF in patients with two-level cervical DDD were eligible for inclusion. Primary outcomes were surgical success rates and secondary surgery rates. Secondary outcomes were scores on the Neck Disability Index (NDI) and Visual Analogue Scale (VAS) for neck and arm pain, as well as the Japanese Orthopaedic Association (JOA) score for the severity of cervical compression myelopathy and complication rates. Results: In total, eight studies (two RCTs, four retrospective studies, and two prospective studies) with a total of 1155 patients (CDA: 598; ACDF: 557) were included. Pooled results revealed that CDA was associated with a significantly higher overall success rate (OR, 2.710, 95% CI: 1.949–3.770) and lower secondary surgery rate (OR, 0.254, 95% CI: 0.169–0.382) compared to ACDF. In addition, complication rates were significantly lower in the CDA group than in the ACDF group (OR, 0.548, 95% CI: 0.326 to 0.919). CDA was also associated with significantly greater improvements in neck pain VAS than ACDF. No significant differences were found in improvements in the arm VAS, NDI, and JOA scores between the two procedures. Conclusions: CDA may provide better postoperative outcomes for surgical success, secondary surgery, pain reduction, and postoperative complications than ACDF for treating patients with two-level cervical DDD.

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Section: Search Resultsmentioning

confidence: 99%

Section: Meta-analysis Of Secondary Outcomesmentioning

confidence: 94%

Section: Characteristics Of Included Studies and Baseline Patient Dem...mentioning

confidence: 99%

mentioning

confidence: 99%

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Cervical Disc Arthroplasty (CDA) versus Anterior Cervical Discectomy and Fusion (ACDF) for Two-Level Cervical Disc Degenerative Disease: An Updated Systematic Review and Meta-Analysis

Chen,

Yang,

2024

JCM

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“…However, no statistically significant differences were observed, likely due to limitations in sample size. Several studies have failed to demonstrate a significant impact of HO on patient outcomes, and furthermore, HO did not influence postoperative cervical alignment [ 32 , 33 ]. Hence, the clinical and radiographic implications of HO remain elusive.…”

Section: Discussionmentioning

confidence: 99%

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

et al. 2023

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Introduction According to the different numbers and relative locations of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF), three-level hybrid surgery (HS) has many constructs. The purpose of this retrospective study was to compare the sagittal alignment parameters of HS and ACDF for cervical degenerative disc disease (CDDD) and the association of the respective parameters. Methods This study involved patients with three-level CDDD who underwent ACDF or HS at our institution between June 2012 and August 2021. This follow-up included one-level CDR and two-level ACDF (type I group), two-level CDR and one-level ACDF (type II group) and three-level ACDF. Cervical sagittal alignment parameters included cervical lordosis (CL), segment alignment (SA), T1 slope (T1S), C2–C7 sagittal vertical axis (SVA), T1S-CL, C2 slope (C2S), occipital to C2 angle (O-C2A) and segment range of motion (ROM). Postoperative complications included adjacent segment degeneration, imbalance, prosthetic subsidence and heterotopic ossification. Results The three groups with a total of 106 patients were better matched in terms of demographics. Patients who underwent HS had significantly higher CL than those who underwent ACDF at 1 week, 6 months, 12 months and the final follow-up after surgery, as well as significantly better SA at 12 months and the final follow-up. There was no significant difference in T1S, SVA, T1S-CL, C2S, O-C2A or segment ROM among the three groups after surgery. The T1S-CL was significantly associated with C2S in the type I and type II groups at the preoperative and final follow-up. There was no significant difference in postoperative complications among the three groups. Conclusions Most improvements in cervical sagittal alignment (CL, SA, T1S, SVA, T1S-CL, C2S, O-C2A, and segmental ROM) were observed in all three groups postoperatively. HS was more advantageous than ACDF in the maintenance of postoperative CL and SA. Thus, three-level HS may be better for maintaining cervical curvature. The number of replacement segments differed in those who underwent HS but did not affect the correlation between T1S-CL and C2S, both of which are well balanced.

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Treatment of the two-level degenerative cervical disk diseases based on algorithmic anterior approach: a multicenter prospective study

Byvaltsev,

Kalinin,

Aliyev

et al. 2023

Neurosurg Rev

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Cervical Alignment Analysis Comparing Two-Level Cervical Disc Arthroplasty with Anterior Cervical Discectomy and Fusion with Anterior Plate Fixation

Cited by 5 publications

References 30 publications

Cervical Disc Arthroplasty (CDA) versus Anterior Cervical Discectomy and Fusion (ACDF) for Two-Level Cervical Disc Degenerative Disease: An Updated Systematic Review and Meta-Analysis

Cervical Disc Arthroplasty (CDA) versus Anterior Cervical Discectomy and Fusion (ACDF) for Two-Level Cervical Disc Degenerative Disease: An Updated Systematic Review and Meta-Analysis

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

Treatment of the two-level degenerative cervical disk diseases based on algorithmic anterior approach: a multicenter prospective study

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