Discover cervical disc arthroplasty versus anterior cervical discectomy and fusion in symptomatic cervical disc diseases: A meta-analysis

Shangguan, Lei; Ning, Guangzhi; Tang, Yu; Wang, Zhe; Luo, Zhuojing; Zhou, Yue

doi:10.1371/journal.pone.0174822

Cited by 22 publications

(17 citation statements)

References 42 publications

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“…It is worth pointing out that the frequency of postoperative dysphagia/dysphonia was significantly lower in patients with mobile devices, which is at variance with the study published last year 36. Both the number of secondary surgical interventions at the index level and adverse events (excluding dysphagia/dysphonia) in CDA and ACDF groups were not statistically different, in agreement with the results of the previous studies 6,11,26,36,41. This is interesting because the previous generations of CDA prostheses (such as Bristol-Cummins) were known to cause subluxation, screw damage, and dysphagia 42.…”

Section: Discussionsupporting

confidence: 83%

<p>Safety and efficacy of cervical disc arthroplasty in preventing the adjacent segment disease: a meta-analysis of mid- to long-term outcomes in prospective, randomized, controlled multicenter studies</p>

Kozłowska

Miękisiak

Łątka

et al. 2019

TCRM

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Objectives Cervical disc arthroplasty (CDA) has become an alternative treatment for cervical radiculopathy and myelopathy. This technique preserves appropriate motion at both the index and adjacent disc levels and consequently may prevent adjacent segment degeneration (ASD). The authors performed a meta-analysis to compare the safety and efficacy of CDA to those of the gold standard, anterior cervical discectomy and fusion (ACDF). Both surgical and clinical parameters were employed to verify the hypothesis that CDA can reduce the risk of ASD. Methods The meta-analysis comprised high-quality randomized controlled trials that compared CDA and ACDF treatments of cervical degenerative disc disease. Included papers reported data for at least one of the following outcomes: 1) surgical parameters, 2) questionnaire clinical indices (pre- and postoperative values), and 3) complication rates at 24 months; in addition, for ASD we analyzed 60 month or longer follow-ups. We used mean differences (MDs) or ORs to compare treatment effects between CDA and ACDF. Results Twenty studies with 3,656 patients (2,140 with CDA and 1,516 with ACDF) met the inclusion criteria. CDA surgery, with mean duration longer than that of ACDF, was associated with higher blood loss. Visual analog scale neck pain score was significantly smaller for CDA (mean difference =−2.30, 95% CI [−3.72; −0.87], P =0.002). The frequency of dysphagia/dysphonia (OR =0.69, 95% CI [0.49; 0.98], P =0.04) as well as the long-term ASD rate for CDA was significantly smaller (OR =0.33, 95% CI [0.21; 0.50], P <0.0001). Conclusion A significantly lower probability of ASD reoperations in the CDA cohort after a 60-month or longer follow-up was the most important finding of this study. Despite the moderate quality of this evidence, the pooled data corroborated for the very first time that CDA was efficacious in preventing ASD.

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Section: Discussionsupporting

confidence: 83%

<p>Safety and efficacy of cervical disc arthroplasty in preventing the adjacent segment disease: a meta-analysis of mid- to long-term outcomes in prospective, randomized, controlled multicenter studies</p>

Kozłowska

Miękisiak

Łątka

et al. 2019

TCRM

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“…Furthermore, in our study, the results of subgroup analysis demonstrated that the difference in secondary surgery at the index level was not statistically significant between the two treatments in Bryan, Discover, and Kineflexl/C prosthesis groups. However, the number of studies included was not large enough, and more studies are needed in future analyses.…”

Section: Discussionsupporting

confidence: 90%

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

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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.

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“…Выполненный метаанализ проспективных рандомизированных исследований не выявил различий в распространенности нежелательных явлений в исследуемых группах пациентов. полученные нами данные согласуются с результатами метаанализов S. Lei с соавторами [27], S. Yi с соавторами [28] и M. Qi с соавторами [29]. Отметим, что наиболее распространенным нежелательным явлением и в обеих группах пациентов являлась дисфагия.…”

Section: Discussionunclassified

Retracted: Comparison Outcomes of Discover Total Disk Arthroplasty and Anterior Cervical Discectomy with Fusion in Surgical Treatment of Cervical Disk Degenerative Disease: a Meta-Analysis of Randomized Trials

Бывальцев¹,

Stepanov²,

Aliev³

et al. 2018

Traumatology and Orthopedics of Russia

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The purpose —to compare the effectiveness of Discover cervical disk arthroplasty (CDA) and anterior cervical discectomy with fusion (ACDF) in the surgical treatment of cervical intervertebral disk (IVD) degenerative disease.Study design —a meta-analysis of randomized clinical trials.Material and Methods.Randomized clinical trials were conducted in the Pubmed, EMBASE, ELibrary and Cochrane Library databases published from 2008 to October 2018, which compared the results of Discover CDA and ACDF techniques in the surgical treatment of cervical IVD degenerative disease. For dichotomous variables, the relative risk and 95% confidence interval were calculated, standardized difference of mean values and their 95% confidence interval were used for continuous variables using the random effects model.Results.This meta-analysis included 9 randomized controlled clinical trials, including the results of surgical treatment of 513 patients with degenerative disease of the cervical IVD. In the CDA group, the operation time was significantly shorter, in contrast to the group of patients who underwent ACDF (p<0.0001). The values of blood loss (p = 0.89), levels of quality of life for patients according to the Neck Disability Index (NDI) (p = 0.22), severity of pain in the cervical spine (p = 0.50) and upper limbs on a visual analogue scale (VAS) (p = 0.16), as well as the prevalence of secondary surgical procedures (p = 0.68) and adverse events (p = 0.40) between the compared groups did not have significant differences. At the same time, significantly large values of the range of motion at the operated level were noted in the CDA group (p<0.00001).Conclusion.Discover CDA in comparison with ACDF has a significantly large values of range of motion at the operated level. At the same time, there were no statistically significant differences in the NDI scores, VAS pain scores in cervical spine and upper limbs, and the prevalence of secondary surgical procedures and adverse events between the compared groups of respondents were not identified.

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Discover cervical disc arthroplasty versus anterior cervical discectomy and fusion in symptomatic cervical disc diseases: A meta-analysis

Cited by 22 publications

References 42 publications

<p>Safety and efficacy of cervical disc arthroplasty in preventing the adjacent segment disease: a meta-analysis of mid- to long-term outcomes in prospective, randomized, controlled multicenter studies</p>

<p>Safety and efficacy of cervical disc arthroplasty in preventing the adjacent segment disease: a meta-analysis of mid- to long-term outcomes in prospective, randomized, controlled multicenter studies</p>

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

Retracted: Comparison Outcomes of Discover Total Disk Arthroplasty and Anterior Cervical Discectomy with Fusion in Surgical Treatment of Cervical Disk Degenerative Disease: a Meta-Analysis of Randomized Trials

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