Jiaquan Luo1, Hongbo Wang2, Jun Peng2, Zhongyuan Deng3, Zhen Zhang2, Shixue Liu2, Daidong Wang2, Ming Gong4, Shuo Tang5. 1. Department of Spine Surgery, Shenzhen Baoan Shajing People's Hospital, Guangzhou Medical University, Shenzhen, P.R. China. Electronic address: luojiaquan666@163.com. 2. Department of Spine Surgery, Shenzhen Baoan Shajing People's Hospital, Guangzhou Medical University, Shenzhen, P.R. China. 3. Department of Orthopaedic Surgery, Shenzhen Baoan Shajing People's Hospital, Guangzhou Medical University, Shenzhen, P.R. China. 4. Department of Spinal Surgery, People's Hospital of Longhua, Shenzhen, P.R. China. 5. Department of Pain Medicine, Shenzhen Nanshan Hospital, Shenzhen, P.R. China.
Abstract
BACKGROUND: The concern of adjacent segment disease (ASD) has led to the development of motion-preserving technologies, such as cervical disc arthroplasty (CDA). However, there is still controversy whether CDA is superior to anterior cervical decompression and fusion (ACDF) as to the incidence of ASD. The purpose of this study is to evaluate the rate of ASD between CDA and ACDF. METHODS: Systematic searches of all relevant studies through November 2017 were identified from the Cochrane Library, PubMed, Embase, and CNKI. Randomized controlled trials comparing the clinical effectiveness of CDA and ACDF for cervical degenerative disc disease (DDD) were included. Two independent reviewers searched and assessed all literature according to the standard of Cochrane systematic review. Data extraction and quality assessment were conducted, and RevMan 5.2 was used for data analysis. The random effects model was used if there was heterogeneity between studies; otherwise, the fixed effects model was used. RESULTS: Twenty-one studies were included in our meta-analysis. The pooled data revealed that the CDA group had significantly lower adjacent segment diseases than the ACDF group did. Furthermore, there were fewer adjacent segment reoperations in the CDA group compared with the ACDF group. CONCLUSIONS: In this meta-analysis, we conclude that CDA was better than the ACDF in terms of ASD and adjacent segment reoperations. This conclusion suggests that CDA is a superior alternative invention for the treatment of cervical DDD to preserve cervical range of motion and reduce the risk of ASD; however, this requires further validation and investigation in larger sample-size prospective and randomized studies with long-term follow-up.
BACKGROUND: The concern of adjacent segment disease (ASD) has led to the development of motion-preserving technologies, such as cervical disc arthroplasty (CDA). However, there is still controversy whether CDA is superior to anterior cervical decompression and fusion (ACDF) as to the incidence of ASD. The purpose of this study is to evaluate the rate of ASD between CDA and ACDF. METHODS: Systematic searches of all relevant studies through November 2017 were identified from the Cochrane Library, PubMed, Embase, and CNKI. Randomized controlled trials comparing the clinical effectiveness of CDA and ACDF for cervical degenerative disc disease (DDD) were included. Two independent reviewers searched and assessed all literature according to the standard of Cochrane systematic review. Data extraction and quality assessment were conducted, and RevMan 5.2 was used for data analysis. The random effects model was used if there was heterogeneity between studies; otherwise, the fixed effects model was used. RESULTS: Twenty-one studies were included in our meta-analysis. The pooled data revealed that the CDA group had significantly lower adjacent segment diseases than the ACDF group did. Furthermore, there were fewer adjacent segment reoperations in the CDA group compared with the ACDF group. CONCLUSIONS: In this meta-analysis, we conclude that CDA was better than the ACDF in terms of ASD and adjacent segment reoperations. This conclusion suggests that CDA is a superior alternative invention for the treatment of cervical DDD to preserve cervical range of motion and reduce the risk of ASD; however, this requires further validation and investigation in larger sample-size prospective and randomized studies with long-term follow-up.
Authors: Pierce D Nunley; Eubulus J Kerr; David A Cavanaugh; Phillip Andrew Utter; Peter G Campbell; Rishi Wadhwa; Kelly A Frank; Kyle E Marshall; Marcus B Stone Journal: Int J Spine Surg Date: 2020-06-30
Authors: Pierce D Nunley; Eubulus J Kerr; David A Cavanaugh; Phillip Andrew Utter; Peter G Campbell; Rishi Wadhwa; Kelly A Frank; Kyle E Marshall; Marcus B Stone Journal: Int J Spine Surg Date: 2020-06-30
Authors: Julian L Gendreau; Lily H Kim; Payton N Prins; Marissa D'Souza; Paymon Rezaii; Arjun V Pendharkar; Eric S Sussman; Allen L Ho; Atman M Desai Journal: Global Spine J Date: 2019-11-21