Top

European Spine Journal

Published in:

01-05-2014 | Review Article

Mid- to long-term outcomes after cervical disc arthroplasty compared with anterior discectomy and fusion: a systematic review and meta-analysis of randomized controlled trials

Authors: Chunpeng Ren, Yueming Song, Youdi Xue, Xi Yang

Published in: European Spine Journal | Issue 5/2014

Abstract

Purpose

To evaluate the mid- to long-term clinical outcomes after cervical disc arthroplasty (CDA) as compared with anterior cervical discectomy and fusion (ACDF) for the treatment of symptomatic cervical disc disease.

Methods

A systematic review and a meta-analysis were performed for articles published up to March 2013. Randomized controlled trials that reported mid- to long-term outcomes (≥48 months) after CDA as compared with ACDF were included. Two authors independently extracted the articles and the predefined data.

Results

Five US Food and Drug Administration randomized controlled trials that reported 4–6 years of follow-up data were retrieved. Patients who underwent CDA had a lower mid- to long-term rate of reoperation and had greater mid- to long-term improvements in the Neck Disability Index, neck and arm pain scores, and Short Form 36 Health Survey physical component score than did those who underwent ACDF. Segmental motion was maintained in patients who underwent CDA. The mid- to long-term rates of adjacent segment disease and neurological success were not significantly different between the two groups.

Conclusions

CDA may result in better mid- to long-term functional recovery and a lower rate of subsequent surgical procedures than ACDF would. A review of the literature showed that only an insufficient number of studies had investigated adjacent segment disease; therefore, it is mandatory that adequate future research should focus in this direction.

Bohlman HH, Emery SE, Goodfellow DB, Jones PK (1993) Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of 122 patients. J Bone Jt Surg Am 75(9):1298–1307

Gore D, Sepic S (1984) Anterior cervical fusion for degenerated or protruded discs: a review of 146 patients. Spine 9:667–671PubMedCrossRef

Emery SE, Bohlman HH, Bolesta MJ, Jones PK (1998) Anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy. 2- to 17-year followup. J Bone Jt Surg Am 80:941–951CrossRef

Yue WM, Brodner W, Highland T (2005) Long-term results after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study. Spine (Phila Pa 1976) 30:2138–2144CrossRef

Goffin J, Geusens E, Vantomme N, Quintens E, Waerzeggers Y, Depreitere B (2004) Long-term follow-up after interbody fusion of the cervical spine. J Spin Disord Tech 17:79–85CrossRef

Eck JC, Humphreys SC, Lim TH (2002) Biomechanical study on the effect of cervical spine fusion on adjacent-level intradiscal pressure and segmental motion. Spine (Phila Pa 1976) 27:2431–2434CrossRef

Matsunaga S, Kabayama S, Yamamoto T (1999) Strain on intervertebral discs after anterior cervical decompression and fusion. Spine (Phila Pa 1976) 24:670–675CrossRef

Hilibrand AS, Carlson GD, Palumbo MA (999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Jt Surg Am 81:519–528

Wigfield C, Gill S, Nelson R (2002) Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg 96:17–21PubMed

10.

Tian W, Han X, Li ZY, Mao JP, Sun YQ, Albert TJ (2013) Reversal of anterior cervical discectomy and fusion with cervical artificial disc replacement regain motion after 9 years fusion. J Spin Disord Tech 26:55–59CrossRef

11.

Upadhyaya CD, Wu JC, Trost G, Haid RW, Traynelis VC (2012) Analysis of the three US food and drug Administration investigational device exemption cervical arthroplasty trials. J Neurosurg Spine 16(3):216–228PubMedCrossRef

12.

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

13.

Heller JG, Sasso RC, Papadopoulos SM, Anderson PA, Fessler RG, Hacker RJ et al (2009) Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial. Spine (Phila Pa 1976) 34:101–107CrossRef

14.

Mummaneni P, Burkus J, Haid R, Traynelis V, Zdeblick T (2007) Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine 6:198–200PubMedCrossRef

15.

Murrey D, Janssen M, Delamarter R, Goldstein J, Zigler J, Tay 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

16.

Cason GW, Herkowitz HN (2013) Cervical intervertebral disc replacement. J Bone Jt Surg Am 95(3):279–285CrossRef

17.

Bartels RH, Donk R, Verbeek AL (2010) No justification for cervical disk prostheses in clinical practice: a meta-analysis of randomized controlled trials. Neurosurgery 66:1153–1160PubMedCrossRef

18.

Zechmeister I, Winkler R, Mad P (2011) Artificial total disc replacement versus fusion for the cervical spine: a systematic review. Eur Spine J 20:177–184PubMedCentralPubMedCrossRef

19.

Chen J, Wang X, Bai W, Shen X, Yuan W (2012) Prevalence of heterotopic ossification after cervical total disc arthroplasty: a meta-analysis. Eur Spine J 21:674–680PubMedCentralPubMedCrossRef

20.

Botelho RV, Moraes OJ, Fernandes GA, Buscariolli Ydos S, Bernardo WM (2010) A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration. Neurosurg Focus 28(6):E5PubMedCrossRef

21.

Shea B, Dube C, Moher D (2006) Assessing the quality of reports os systematic reviews: the Quorum statement compared to other tools. In: Egger M, Smith GD, Altman DG (eds) Systematic reviews in health care: meta-Analysis in context. BMJ Publishing Group, London, pp 122–139

22.

Deeks JJ, Higgins JPT, Altman DG (eds) (2011) Chapter 9: analysing data and undertaking meta-analyses. In: Higgins JPT, Green S (eds). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org. ed: The Cochrane Collaboration

23.

Higgins JP, Altman DG, Gotzsche PC (2011) The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928PubMedCentralPubMedCrossRef

24.

Guyatt GH, Oxman AD, Schünemann HJ, Tugwell P, Knottnerus A (2011) GRADE guidelines: a new series of articles in the journal of clinical epidemiology. J Clin Epidemiol 64:380–382PubMedCrossRef

25.

Burkus JK, Haid RW, Traynelis VC, Mummaneni PV (2010) Long-term clinical and radiographic outcomes of cervical disc replacement with the prestige disc: results from a prospective randomized controlled clinical trial. J Neurosurg Spine 13:308–318PubMedCrossRef

26.

Coric D, Kim PK, Clemente JD, Boltes MO, Nussbaum M, James S (2013) Prospective randomized study of cervical arthroplasty and anterior cervical discectomy and fusion with long-term follow-up: results in 74 patients from a single site. J Neurosurg Spine 18:36–42PubMedCrossRef

27.

Nunley PD, Jawahar A, Cavanaugh DA, Gordon CR, Kerr EJ, Utter PA (2013) Symptomatic adjacent segment disease after cervical total disc replacement: re-examining the clinical and radiological evidence with established criteria. Spine J 13:5–12PubMedCrossRef

28.

Sasso RC, Anderson PA, Riew KD, Heller JG (2011) Results of cervical arthroplasty compared with anterior discectomy and fusion: 4-year clinical outcomes in a prospective, randomized controlled trial. J Bone Jt Surg Am 93:1684–1692CrossRef

29.

Zigler JE, Delamarter R, Murrey D, Spivak J, Janssen M (2013) ProDisc-C and anterior cervical discectomy and fusion as surgical treatment for single-level cervical symptomatic degenerative disc disease: 5-year results of a food and drug administration study. Spine 38(3):203–209PubMedCrossRef

30.

Kim S, Limson M, Kim S (2009) Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J 18:218–231PubMedCentralPubMedCrossRef

31.

Robertson J, Papadopoulos S, Traynelis V (2005) Assessment of adjacent-segment disease in patients treated with cervical fusion or arthroplasty: a prospective 2-year study. J Neurosurg Spine 3:417–423PubMedCrossRef

32.

Hilibrand AS, Robbins M (2004) Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? Spine J 4(6 suppl):190S–194SPubMedCrossRef

33.

Jawahar A, Cavanaugh DA, Kerr EJ 3rd, 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

34.

Nunley PD, Jawahar A, Kerr EJ 3rd, Gordon CJ, Cavanaugh DA, Birdsong EM et al (2012) Factors affecting the incidence of symptomatic adjacent-level disease in cervical spine after total disc arthroplasty: 2- to 4-year follow-up of three prospective randomized trials. Spine (Phila Pa 1976) 37:445–451CrossRef

35.

Yang BH, Li HP, Zhang T, He XJ, Xu SY (2012) The incidence of adjacent segment degeneration after cervical disc arthroplasty (CDA): a meta analysis of randomized controlled trials. PLoS ONE 7(4):e35032PubMedCentralPubMedCrossRef

36.

Barna M, Stulik J, Kryl J, Vyskocil T, Nesnidal P (2012) ProDisc-C total disc replacement. A 4-year prospective monocentric study. Acta chirurgiae orthopaedicae et traumatologiae cechoslovaca 79:512–519PubMed

37.

Suchomel P, Jurák L, Benes V III, Brabec R, Bradác O, Elgawhary S (2010) Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up. Eur Spine J 19:307–315PubMedCentralPubMedCrossRef

38.

McAfee PC, Cunningham BW, Devine J, Williams E, Yu-Yahiro J (2003) Classification of heterotopic ossification (HO) in artificial disk replacement. J Spin Disord Tech 16:384–389CrossRef

39.

Delamarter RB, Zigler J (2013) 5-year reoperation rates, cervical total disc replacement versus fusion, results of a prospective randomized clinical trial. Spine 38(9):711–717PubMedCrossRef

40.

Yin S, Yu X, Zhou SL, Yin ZH, Qiu YS (2013) Is cervical disc arthroplasty superior to fusion for treatment of symptomatic cervical disc disease? A meta-analysis. Clin Orthop Relat Res 471(6):1901–1919

41.

Fallah A, Elie A, Ebrahim S, Ibrahim GM, Mansouri A, Foote CJ et al (2012) Anterior cervical discectomy with arthroplasty versus arthrodesis for single-level cervical spondylosis: a systematic review and meta-analysis. PLoS ONE 7(8):e43407PubMedCentralPubMedCrossRef

42.

Pickett GE, Sekhon LH, Sears WR, Duggal N (2006) Complications with cervical arthroplasty. J Neurosurg Spine 4:98–105PubMedCrossRef

Title: Mid- to long-term outcomes after cervical disc arthroplasty compared with anterior discectomy and fusion: a systematic review and meta-analysis of randomized controlled trials
Authors: Chunpeng Ren
Yueming Song
Youdi Xue
Xi Yang
Publication date: 01-05-2014
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 5/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-014-3220-3

At a glance: The STEP trials

Springer Medicine

Mid- to long-term outcomes after cervical disc arthroplasty compared with anterior discectomy and fusion: a systematic review and meta-analysis of randomized controlled trials

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2014

Transoral anterior revision surgeries for basilar invagination with irreducible atlantoaxial dislocation after posterior decompression: a retrospective study of 30 cases

Is the 4 mm height of the vertebral artery groove really a limitation of C1 pedicle screw insertion?

Comparison of unilateral versus bilateral pedicle screw fixation in degenerative lumbar diseases: a meta-analysis

The height for screw index (HSI) predicts the development of C2 nerve dysfunction associated with C1 lateral mass screw fixation for atlantoaxial instability

Can unilateral-approach minimally invasive transforaminal lumbar interbody fusion attain indirect contralateral decompression? A preliminary report of 66 MRI analysis

Computed tomography-based classification of axis vertebra: choice of screw placement