Jian Chen1, Shun-wu Fan, Xin-wei Wang, Wen Yuan. 1. Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University and Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, Hangzhou, China.
Abstract
OBJECTIVE: The purpose of this review was to investigate whether cervical total disc arthroplasty (CTDA) preserves motion of the treated level and what its effect is on adjacent segments. METHODS: Relevant published reports were collected from PubMed, Medline and Cochrane library. The original studies were considered eligible only if the range of motion (ROM) of the index or adjacent level had been investigated. A meta-analysis was then performed on the collected data. Statistical heterogeneity across the various trials was tested using Cochran's Q statistic and I (2) ; in the case of heterogeneity, a random effect model was used. RESULTS: The weighted mean differences (WMDs) of the index level were 0.34 (95% confidence interval [CI], -0.53∼1.21, P = 0.440) and 0.23 (95% CI, -1.92∼2.38, P = 0.834) in all included studies and randomized control trials (RCTs), respectively. The WMDs of the cranial adjacent levels, caudal adjacent levels and whole cervical spines were 1.01 (95% CI, 0.55∼1.47, P = 0.000), 1.10 (95% CI, 0.61∼1.59, P = 0.000) and 3.40 (95% CI, -6.02∼12.82, P = 0.479), respectively. CONCLUSION: These findings suggest that the protective effect against adjacent segment degeneration provided by cervical arthroplasty might not be as good as has been believed. Long-term supporting evidence is still needed.
OBJECTIVE: The purpose of this review was to investigate whether cervical total disc arthroplasty (CTDA) preserves motion of the treated level and what its effect is on adjacent segments. METHODS: Relevant published reports were collected from PubMed, Medline and Cochrane library. The original studies were considered eligible only if the range of motion (ROM) of the index or adjacent level had been investigated. A meta-analysis was then performed on the collected data. Statistical heterogeneity across the various trials was tested using Cochran's Q statistic and I (2) ; in the case of heterogeneity, a random effect model was used. RESULTS: The weighted mean differences (WMDs) of the index level were 0.34 (95% confidence interval [CI], -0.53∼1.21, P = 0.440) and 0.23 (95% CI, -1.92∼2.38, P = 0.834) in all included studies and randomized control trials (RCTs), respectively. The WMDs of the cranial adjacent levels, caudal adjacent levels and whole cervical spines were 1.01 (95% CI, 0.55∼1.47, P = 0.000), 1.10 (95% CI, 0.61∼1.59, P = 0.000) and 3.40 (95% CI, -6.02∼12.82, P = 0.479), respectively. CONCLUSION: These findings suggest that the protective effect against adjacent segment degeneration provided by cervical arthroplasty might not be as good as has been believed. Long-term supporting evidence is still needed.
Authors: Anton E Dmitriev; Bryan W Cunningham; Nianbin Hu; Gregory Sell; Franco Vigna; Paul C McAfee Journal: Spine (Phila Pa 1976) Date: 2005-05-15 Impact factor: 3.468
Authors: Jan Goffin; Frank Van Calenbergh; Johannes van Loon; Adrian Casey; Pierre Kehr; Klaus Liebig; Bengt Lind; Carlo Logroscino; Rosella Sgrambiglia; Vincent Pointillart Journal: Spine (Phila Pa 1976) Date: 2003-12-15 Impact factor: 3.468