Comparison between cervical disc arthroplasty and conservative treatment for patients with single level cervical radiculopathy at C5/6

He, Aijuan; Xie, Dong; Qu, Bo; Cai, Xiaomin; Kong, Qin; Yang, Lili; Chen, Xiongsheng; Jia, Lianshun

doi:10.1016/j.ijsu.2018.01.033

Cited by 3 publications

(4 citation statements)

References 29 publications

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“…Non-surgical treatments relieve symptoms of cervical radiculopathy in more than half of patients ( 5 , 6 ). Surgical treatments are recommended for patients not responding to conservative treatment ( 1 ).…”

Section: Introductionmentioning

confidence: 99%

“…Cervical radiculopathy is an aging-related disease that typically manifests as neck and shoulder pain (1). The age-adjusted incidence of cervical radiculopathy is 83 per 100,000 people, with men having a slightly higher incidence than women (2).…”

Section: Introductionmentioning

confidence: 99%

“…Non-surgical treatments relieve symptoms of cervical radiculopathy in more than half of patients (5,6). Surgical treatments are recommended for patients not responding to conservative treatment (1). Some meta-analyses compared the effectiveness of surgical treatments for cervical radiculopathy.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Efficacy and Safety of Surgical Treatments in Patients With Pure Cervical Radiculopathy

Gao

Wei

Zhu

et al. 2022

Front. Public Health

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BackgroundTraditionally paired meta-analysis revealed inconsistencies in the safety and effectiveness of surgical interventions. We conducted a network meta-analysis to assess various treatments' clinical efficacy and safety for pure cervical radiculopathy.MethodsThe Embase, PubMed, and Cochrane Library databases were searched for randomized controlled trials (RCTs) comparing different treatment options for patients with pure cervical radiculopathy from inception until October 23, 2021. The primary outcomes were postoperative success rates, postoperative complication rates, and postoperative reoperation rates. The pooled data were subjected to a random-effects consistency model. The protocol was published in PROSPERO (CRD42021284819).ResultsThis study included 23 RCTs (n = 1,844) that evaluated various treatments for patients with pure cervical radiculopathy. There were no statistical differences between treatments in the consistency model in terms of major clinical effectiveness and safety outcomes. Postoperative success rates were higher for anterior cervical foraminotomy (ACF: probability 38%), posterior cervical foraminotomy (PCF: 24%), and anterior cervical discectomy with fusion and additional plating (ACDFP: 21%). Postoperative complication rates ranked from high to low as follows: cervical disc replacement (CDR: probability 32%), physiotherapy (25%), ACF (25%). Autologous bone graft (ABG) had better relief from arm pain (probability 71%) and neck disability (71%). Among the seven surgical interventions with a statistical difference, anterior cervical discectomy with allograft bone graft plus plating (ABGP) had the shortest surgery time.ConclusionsAccording to current results, all surgical interventions can achieve satisfactory results, and there are no statistically significant differences. As a result, based on their strengths and patient-related factors, surgeons can exercise discretion in determining the appropriate surgical intervention for pure cervical radiculopathy.Systematic Review Registration: CRD42021284819.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Efficacy and Safety of Surgical Treatments in Patients With Pure Cervical Radiculopathy

Gao

Wei

Zhu

et al. 2022

Front. Public Health

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“…Cervical disc degenerative disease (CDDD) is a common clinical spinal surgery disease, which has a great impact on the quality of life of middle-aged and elderly patients [1][2][3][4][5]. At present, although this is challenged by many new surgical treatments [5][6][7], anterior cervical discectomy and fusion (ACDF) is still the best choice for the treatment of CDDD [8][9][10]. After decades of clinical application, the clinical effect of ACDF has been fully demonstrated.…”

Section: Introductionmentioning

confidence: 99%

Over-correction of Curvature in Surgical Segments Cause the Non-surgical Curvature Loss in One- and Two-level Anterior Cervical Discectomy and Fusion

Guo

Líu

Yang

et al. 2021

Preprint

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Background: In some patients with anterior cervical disecetomy anf fusion (ACDF), the correction degree of cervical curvature after surgery is less than that of the surgical segment curvature, which we defined as non-surgical curvature loss (NSCL). This study aims to elucidate the notification of NSCL and its possible causes. Methods: A retrospective analysis was conducted on 122 patients with one- or two-level ACDF from October 2012 to June 2017. The pre-operative and post-operative Cobb angle of C2-7, surgical segments and non-surgical segments were measured and analyzed by lateral cervical X-ray. Results: All patients were followed up for 22.87±3.15 months. Both one- and two-level ACDF could improve the cervical curvature. In the evaluation of NSCL, it was found that the incidence was 37.50% (27/72) in one-level ACDF and 48.00% (24/50) in two-level ACDF. Furthermore, the NSCL does not spontaneously recover after surgery. By comparing patients with and without NSCL, it was found that patients with NSCL had a significantly higher correction degree in the surgical segments, while the degree of NSCL was significantly and positively correlated with the correction degree of the surgical segments. For patients with a slight correction degree of surgical segment, the cervical curvature was well-improved and maintained post-operatively. Conclusion: In summary, the correction of the surgical segment curvature in ACDF should not be overemphasized, because excessive correction may cause NSCL. Even if the surgical segment curvature is only slightly corrected, a good improvement in cervical curvature can still be attained.

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(Cost‐)effectiveness of personalised multimodal physiotherapy compared to surgery in patients with cervical radiculopathy: A systematic review

Klein Heerenbrink,

Coenen,

Coppieters

et al. 2024

Evaluation Clinical Practice

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RationaleCervical radiculopathy is initially typically managed conservatively. Surgery is indicated when conservative management fails or with severe/progressive neurological signs. Personalised multimodal physiotherapy could be a promising conservative strategy. However, aggregated evidence on the (cost‐)effectiveness of personalised multimodal physiotherapy compared to surgery with/without post‐operative physiotherapy is lacking.Aim/ObjectivesTo systematically summarise the literature on the (cost‐)effectiveness of personalised multimodal physiotherapy compared to surgery with or without post‐operative physiotherapy in patients with cervical radiculopathy.MethodsPubMed, Embase, CINAHL, PsycINFO and Web of Science were searched from inception to 1st of March 2023. Primary outcomes were effectiveness regarding costs, arm pain intensity and disability. Neck pain intensity, perceived recovery, quality of life, neurological symptoms, range‐of‐motion, return‐to‐work, medication use, (re)surgeries and adverse events were considered secondary outcomes. Randomised clinical trials comparing personalised multimodal physiotherapy versus surgical approaches with/without post‐operative physiotherapy were included. Two independent reviewers performed study selection, data‐extraction, and risk of bias assessment using the Cochrane RoB 2 and Consolidated Health Economic Evaluation Reporting Standards statement. Certainty of the evidence was determined using Grading of Recommendations, Assessment, Development and Evaluations.ResultsFrom 2109 records, eight papers from two original trials, with 117 participants in total were included. Low certainty evidence showed there were no significant differences on arm pain intensity and disability, except for the subscale ‘heavy work’ related disability (12 months) and disability at 5–8 years. Cost‐effectiveness was not assessed. There was low certainty evidence that physiotherapy improved significantly less on neck pain intensity, sensory loss and perceived recovery compared to surgery with/without physiotherapy. Low certainty evidence showed there were no significant differences on numbness, range of motion, medication use, and quality of life. No adverse events were reported.ConclusionConsidering the clinical importance of accurate management recommendations and the current low level of certainty, high‐quality cost‐effectiveness studies are needed.

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Comparison between cervical disc arthroplasty and conservative treatment for patients with single level cervical radiculopathy at C5/6

Abstract: CDA surgery stabilized C5/6 vertebrae and increased the CROM and horizontal displacement of upper adjacent C4/5 vertebrae.

Cited by 3 publications

References 29 publications

Clinical Efficacy and Safety of Surgical Treatments in Patients With Pure Cervical Radiculopathy

Clinical Efficacy and Safety of Surgical Treatments in Patients With Pure Cervical Radiculopathy

Over-correction of Curvature in Surgical Segments Cause the Non-surgical Curvature Loss in One- and Two-level Anterior Cervical Discectomy and Fusion

(Cost‐)effectiveness of personalised multimodal physiotherapy compared to surgery in patients with cervical radiculopathy: A systematic review

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