Comparison of Outcomes of Single-Level Anterior Cervical Discectomy With Fusion and Single-Level Artificial Cervical Disc Replacement for Single-Level Cervical Degenerative Disc Disease

Pandey, Praveen Kumar; Pawar, Inder; Gupta, Jayesh K.; Verma, Raaghav Rai

doi:10.1097/brs.0000000000001696

Cited by 27 publications

(23 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Anterior cervical discectomy and fusion (ACDF) has a long history of successfully treating cervical spondylotic disease and other cervical pathologies, and at present, it is still regarded as a relatively safe and effective treatment option [1][2][3]. However, ACDF is associated with potential concerns, and one overarching concern is the development of symptomatic adjacent segment disease (ASD) after surgery.…”

Section: Introductionmentioning

confidence: 99%

Mid- to long-term rates of symptomatic adjacent-level disease requiring surgery after cervical total disc replacement compared with anterior cervical discectomy and fusion: a meta-analysis of prospective randomized clinical trials

Deng

Líu

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

Background Thus far, no meta-analysis focusing on the mid- to long-term incidence of adjacent segment disease requiring surgery after cervical total disc replacement and anterior cervical discectomy and fusion has been published yet. This study aimed to compare mid- to long-term rates of symptomatic adjacent-level disease requiring surgery after cervical disc replacement and anterior cervical fusion. Methods A meta-analysis was performed, and only randomized controlled trials with a follow-up period of more than 48 months reporting rates of symptomatic adjacent-level disease requiring surgery after cervical total disc replacement and anterior cervical discectomy and fusion were included. Results The analysis revealed that the overall rate of symptomatic adjacent-level disease requiring surgery in the cervical disc replacement group was significantly lower than that of the anterior cervical fusion group at 48–120 months’ follow-up. The subgroup analysis of different follow-up periods also yielded the same results. The rate of symptomatic adjacent-level disease requiring surgery in the cervical disc replacement group using unrestricted prosthesis was significantly lower than that of the anterior cervical fusion group (p < 0.001); however, the cervical disc replacement group using semi-restricted prosthesis showed no statistical difference compared with the fusion group. Conclusions Our review suggests that cervical disc replacement is preferable to anterior cervical fusion in reducing the incidence of symptomatic adjacent-level disease requiring surgery at mid- to long-term follow-up. A review of the literature also demonstrated that randomized controlled trials investigating the rate of symptomatic adjacent-level disease requiring surgery were insufficient; therefore, studies focusing on this subject with longer-term follow-up are warranted.

show abstract

Section: Introductionmentioning

confidence: 99%

Mid- to long-term rates of symptomatic adjacent-level disease requiring surgery after cervical total disc replacement compared with anterior cervical discectomy and fusion: a meta-analysis of prospective randomized clinical trials

Deng

Líu

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…Then the titles and abstracts were screened, and 51 records were evaluated for eligibility. Finally, 21 studies were included in this meta‐analysis. Information about the search process is provided in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Several studies have compared the effectiveness and safety of ACDF and CDA for the treatment of cervical degenerative disc disease, and most of the results demonstrate that CDA is similar to ACDF, or even better in regard to some clinical and radiographic outcomes. However, most of those studies were evaluated as low quality, and may overestimate the effectiveness of CDA. In addition, a meta‐analysis conducted by Zhang et al .…”

Section: Introductionmentioning

confidence: 95%

Secondary Surgery after Cervical Disc Arthroplasty versus Fusion for Cervical Degenerative Disc Disease: A Meta‐analysis with Trial Sequential Analysis

Zhu¹,

Kan²,

Cao³

et al. 2018

Orthopaedic Surgery

View full text Add to dashboard Cite

The purpose of this meta-analysis was to explore whether cervical disc arthroplasty (CDA) was superior to anterior cervical discectomy and fusion (ACDF) in reducing secondary surgery. PubMed, EMBASE, and the Cochrane Library databases were systematically searched. Outcomes were reported as relative risk (RR) with the corresponding 95% confidence interval (CI). The pooled data was calculated using a random-effect model. We also used the trial sequential analysis (TSA) to further verify our results and obtain more moderate estimates. Twenty-one studies with 4208 patients were included in this meta-analysis. The results indicated that compared with ACDF, CDA had fewer frequency of secondary surgery at the index level (RR, 0.47; 95%CI, 0.36-0.63; P < 0.05) and adjacent level (RR, 0.48; 95%CI, 0.36-0.65; P < 0.05), and the differences were statistically significant. In addition, in terms of the overall frequency of secondary surgery at the index and adjacent level, CDA was also significantly superior to ACDF (RR, 0.49; 95%CI, 0.41-0.60; P < 0.05). TSA demonstrated that adequate and decisive evidence had been established. Regarding the frequency of secondary surgery, CDA was significantly superior to ACDF. It was supposed that CDA may be a better surgical intervention to reduce the rate of secondary surgery for patients with cervical degenerative disc disease.

show abstract

“…In these cases, the most recent data was utilized and the earlier studies by these authors were not included. Zoëga et al 4 Zhang et al 23 20 Porchet et al 5 Coric et al 24 22 Chen et al 6 Ha et al 25 21 Schils et al 7 Chen et al 26 20 Bindal et al 8 Kasliwal et al 27 22 Mummaneni et al 9 Phillips et al 28 21 Nabhan et al 10 Zigler et al 29 22 Oktenoglu et al 11 Janssen et al 30 21 Cosar et al 12 Skeppholm et al 31 20 Fernández-Fairen et al 13 Arnold et al 32 22 Bhadra et al 14 Hisey et al 33 18 Heller et al 15 Loumeau et al 34 20 Murrey et al 16 Richter et al 35 20 Nabhan et al 17 Burkus et al 36 19 Burkus et al 18 Pandey et al 37 18 Delamarter et al 19 Razankovic et al 38 20 Garrido et al 20 Sasso et al 39 19 Lö fgren et al 21 Arts et al 40 18 Maldonado et al 22 Mean + SD 19.9 + 2.…”

Section: Eligibility Criteriamentioning

confidence: 99%

The Role of Anterior Cervical Discectomy and Fusion on Relieving Axial Neck Pain in Patients With Single-Level Disease: A Systematic Review and Meta-Analysis

Oitment

Watson

Lam

et al. 2019

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Systematic review and meta-analysis. Objectives: This study aims to evaluate the effects of anterior cervical decompression and fusion (ACDF) on axial neck pain in adult patients receiving surgery for myelopathy, radiculopathy, or a combination of both. Methods: Two independent reviewers completed a librarian-assisted search of 4 databases. Visual Analogue Scale (VAS) and Neck Disability Index (NDI) scores were extracted preoperatively and at 3, 6, 12, 24, 36, 48, and 48+ months postoperatively for ACDF groups and pooled using a random-effects model. Results: Of 17 850 eligible studies, 37 were included for analysis, totaling 2138 patients analyzed with VAS and 2477 with NDI score. Individual VAS mean differences were reduced at 6 weeks (−2.5 [95% confidence interval (CI): −3.5 to −1.6]), 3 months (−2.9 [−3.7 to −2.2]), 6 months (−3.2 [−3.9 to −2.6]), 12 months (−3.7 [−4.3 to −3.1]), 24 months (−4.0 [−4.4 to −3.5]), 48 months (−4.6 [−5.5 to −3.8]), and >48 months (−4.7 [−5.8 to −3.6]) follow-up ( P < .0001 for all endpoints). Individual NDI mean differences were reduced at 6 weeks (−26.7 [−30.9 to −22.6]), 3 months (−29.8 [−32.7 to −26.8]), 6 months (−31.2 [−35.5 to −26.8)], 12 months (−29.3 [−33.2 to −25.4]), 24 months (−28.9 [−32.6 to −25.2]), 48 months (−33.1 [−37.4 to −28.7]), and >48 months (−37.6 [−45.9 to −29.3]) follow-up ( P < .0001 for all endpoints). Conclusions: ACDF is associated with a significant reduction in axial neck pain compared with preoperative values in patients being treated specifically for myelopathy or radiculopathy. This influences the preoperative discussions surgeons may have with patients regarding their expectations for surgery. The effects seen are stable over time and represent a clinically significant reduction in axial neck pain.

show abstract

Comparison of Outcomes of Single-Level Anterior Cervical Discectomy With Fusion and Single-Level Artificial Cervical Disc Replacement for Single-Level Cervical Degenerative Disc Disease

Abstract: 2.

Cited by 27 publications

References 10 publications

Mid- to long-term rates of symptomatic adjacent-level disease requiring surgery after cervical total disc replacement compared with anterior cervical discectomy and fusion: a meta-analysis of prospective randomized clinical trials

Mid- to long-term rates of symptomatic adjacent-level disease requiring surgery after cervical total disc replacement compared with anterior cervical discectomy and fusion: a meta-analysis of prospective randomized clinical trials

Secondary Surgery after Cervical Disc Arthroplasty versus Fusion for Cervical Degenerative Disc Disease: A Meta‐analysis with Trial Sequential Analysis

The Role of Anterior Cervical Discectomy and Fusion on Relieving Axial Neck Pain in Patients With Single-Level Disease: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About