Top

European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-07-2015 | Original Article

Comparison of the short- and long-term treatment effect of cervical disk replacement and anterior cervical disk fusion: a meta-analysis

Authors: Aikeremujiang Muheremu, Xiaohui Niu, Zhongyan Wu, Yilixiati Muhanmode, Wei Tian

Published in: European Journal of Orthopaedic Surgery & Traumatology | Special Issue 1/2015

Abstract

Background

Anterior cervical discectomy and fusion (ACDF) has been used as a gold standard for the treatment of cervical spondylosis, but it may cause complications such as pseudarthrosis and junctional degeneration. Cervical disk arthroplasty (CDA) may help overcome such problems, but there are inconsistencies among the published literature on its effectiveness comparing with ACDF.

Methodology

We searched “PubMed” (2000.1–2013.10), “Medline” (2000.1–2013.10), “Elsevier” (2000.1–2013.10), Cochrane library (2008.1–2013.10) databases with the key words of “cervical disk arthroplasy”, “CDA”, “anterior cervical disk fusion”, “ACDF”, “cervical”, “randomized controlled study”, “RCT” and searched for randomized controlled trials comparing the efficacy of ACDF and CDA for the treatment of cervical spondylosis. Neck disability index (NDI), VAS arm pain score, VAS neck pain score, ROM of the adjacent level, SF36-PCS score, SF36-MCS score and patient satisfaction were calculated by Revman5.2 software.

Results

From 1,400 papers found, we chose 18 randomized controlled trials and cohorts evaluating the efficacy of CDA and ACDF on symptomatic cerebral spondylosis. The total number of patients is 3,056, in which 1,576 were in the CDA group and 1,480 were in the ACDF group. The CDA group demonstrated better results than the ACDF group concerning VAS arm pain score 1, 2, 4 years after the surgery, VAS neck pain score 1, 2, 4 years after the surgery, ROM of the adjacent level 1 and 2 years after the surgery, patient satisfaction 1, 2, 4 years after the surgery, NDI scores 1, 2, 4 years after the surgery, SF36-PCS score 1 and 2 years after the surgery and SF36-MCS score at 1 and 4 years after the surgery. There are no significant differences between the groups concerning SF36-PCS score 4 years after the surgery and SF36-MCS score at 2 years after the surgery.

Conclusions

CDA can be an effective alternative method to ACDF for the treatment of cervical spondylosis.

Cloward RB (1958) The anterior approach for removal of ruptured cervical disks. J Neurosurg 15:602–617PubMedCrossRef

Smith GW, Robinson RA (1958) The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am 40-A:607–624PubMed

Murrey D, Janssen M, Delamarter R et al (2009) Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J 9:275–286PubMedCrossRef

Heller JG, Sasso RC, Papadopoulos SM et al (2009) Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion. Spine 34:101–107PubMedCrossRef

Furlan AD, Pennick V, Bombardier C, van Tulder M (2009) updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine (Phila Pa 1976) 34(18):1929–1941CrossRef

Nabhan A, Ahlhelm F, Shariat K, Pitzen T, Steimer O, Steudel W-I, Pape D (2007) The ProDisc-C Prothesis: clinical and radiological experience 1 year after surgery. Spine 32:1935–1941PubMedCrossRef

Kelly MP, Mok JM, Frisch RF, Tay BK (2011) Adjacent segment motion after anterior cervical discectomy and fusion versus ProDisc-C cervical total disk arthroplasty. Spine 36:1171–1179PubMedCrossRef

Murrey D, Janssen M, Delamarter R, Goldstein J, Zigler J, Tay B, Darden B (2009) Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J 9:275–286PubMedCrossRef

Sun P-F, Jia Y-H (2008) Cervical disc prosthesis replacement and interbody fusion- a comparative study. Int Orthop SICOT 32:103–106CrossRef

10.

Coric D, Finger F, Bolles P (2006) Prospective randomized controlled study of the Bryan Cervical Disc: early clinical results from a single investigational site. J Neurosurg Spine 4:31–35PubMedCrossRef

11.

Hacker RJ (2005) Cervical disc arthroplasty: a controlled randomized prospective study with intermediate follow-up results. J Neurosurg Spine 3:424–428PubMedCrossRef

12.

Garrido BJ, Taha TA, Sasso RC (2010) Clinical outcomes of Bryan cervical disc arthroplasty a prospective, randomized, controlled, single site trial with 48-month follow-up. J Spinal Disord Tech 23:367–371PubMedCrossRef

13.

Wang Y, Cai B, Zhang X, Xiao S, Wang Z, Lu N (2008) Clinical outcomes of single level Bryan cervical disc arthroplasty: a prospective controlled study. Chin J Surg 46:328–332PubMed

14.

Murrey DB, Janssen ME, Odum SM, Gottlieb JR, Spector LR, Darden BV (2008) Two-year results of a randomized controlled clinical trial comparing ProDisc-C and anterior cervical discectomy and fusion. SAS J 2:76–85PubMedCentralPubMedCrossRef

15.

Jawahar A, Cavanaugh DA, Kerr EJ III, Birdsong EM, Nunley PD (2010) Total disc arthroplasty does not affect the incidence of adjacent segment degeneration in cervical spine: results of 93 patients in three prospective randomized clinical trials. Spine J 10:1043–1048PubMedCrossRef

16.

Coric D, Cassis J, Carew JD, Boltes MO (2010) Prospective study of cervical arthroplasty in 98 patients involved in 1 of 3 separate investigational device exemption studies from a single investigational site with a minimum 2-year follow-up. J Neurosurg Pediatr 13:715–721

17.

Sasso RC, Smucker JD, Hacker RJ, Heller JG (2007) Artificial disc versus fusion a prospective, randomized study With 2-year follow-up on 99 patients. Spine 32:2933–2940PubMedCrossRef

18.

Auerbach JD, Anakwenze OA, Milby AH, Lonner BS, Balderston RA (2011) Segmental contribution toward total cervical range of motion a comparison of cervical disc arthroplasty and fusion. Spine 36:1593–1599CrossRef

19.

Nabhan A, Ishak B, Steudel W, Ramadhan S, Steimer O (2011) Assessment of adjacent-segment mobility after cervical disc replacement versus fusion: RCT with 1 year’s results. Eur Spine J 20:934–941

20.

Coric D, Nunley PD, Guyer RD, Musante D, Carmody CN (2011) Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex|C artificial disc investigational device exemption study with a minimum 2-year follow-up. J Neurosurg Spine 15:348–358PubMedCrossRef

21.

Phillips FM, Lee JYB, Geisler FH, Cappuccino A, Chaput CD (2013) A prospective, randomized, controlled clinical investigation comparing PCM cervical disc arthroplasty with anterior cervical discectomy and fusion. Spine 38:907–918CrossRef

22.

Ding C, Liu H, Hu T, Shi R, Li T, Geng Q, Hong Y (2012) Clinical outcomes of Prestige LP cervical disc replacement a prospective controlled single site trail with 24-month follow up. Chin J Orthop 32:32–38

23.

Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA (2007) Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine 6:198–209PubMedCrossRef

24.

Bertagnoli R, Yue JJ, Pfeiffer F, Fenk-Mayer A, Lawrence JP, Kershaw T, Nanieva R (2005) Early results after ProDisc-C cervical disc replacement. J Neurosurg Spine 2:403–410PubMedCrossRef

25.

Ponnuraja C (2010) An empirical investigation of meta-analysis using randomized controlled clinical trials in a particular centre. Appl Quant Methods Med 5:166–175

Title: Comparison of the short- and long-term treatment effect of cervical disk replacement and anterior cervical disk fusion: a meta-analysis
Authors: Aikeremujiang Muheremu
Xiaohui Niu
Zhongyan Wu
Yilixiati Muhanmode
Wei Tian
Publication date: 01-07-2015
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue Special Issue 1/2015
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-014-1469-1

At a glance: The STEP trials

Springer Medicine

Comparison of the short- and long-term treatment effect of cervical disk replacement and anterior cervical disk fusion: a meta-analysis

Abstract

Background

Methodology

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methodology

Results

Conclusions

Please log in to get access to this content

Other articles of this Special Issue 1/2015

Correction of severe pelvic obliquity using maximum-width segmental sacropelvic screw fixation: an analysis of 20 neuromuscular scoliosis patients

Prevalence of neuropathic pain after radical sacral chordoma resection: an observational cohort study with 10-year follow-up

A novel technique to assess placement of vertebral pedicle screws on intra-operative lateral radiographs

Immunomodulatory effectiveness of licofelone in preventing epidural fibrosis in post-laminectomy rat

Stand-alone anchored cage versus cage with plating for single-level anterior cervical discectomy and fusion: a prospective, randomized, controlled study with a 2-year follow-up

Is it possible to eliminate the plate-related problems and still achieve satisfactory outcome after multilevel anterior cervical discectomy?