Zihan Peng1, Ying Hong2,3, Yang Meng4, Hao Liu5. 1. Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China. 2. West China School of Nursing, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China. 3. Department of Operating Room, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China. 4. Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China. drmengyang2010@gmail.com. 5. Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China. dr.liuhao6304@hotmail.com.
Abstract
PURPOSE: Anterior cervical discectomy and fusion (ACDF) surgery is commonly performed to treat cervical degenerative disc disease (CDDD). The lost of range of motion (ROM) is also found after ACDF, which contributes to degenerate in adjacent segment disease (ASD). Artificial cervical disc replacement (ACDR), an alternative to ACDF, is developed to preserve the ROM and reduce ASD. This article aims to compare the outcomes between ACDR and ACDF in the short-, mid-, and long-term. METHODS: Databases including Cochrane, Embase, PubMed, and Web of Science were searched. Only RCTs were included in this meta-analysis, and the search strategy followed the requirements of the Cochrane Handbook. The strength of evidence was assessed using GRADE. Two reviewers independently assessed the methodological quality of each included study and extracted the relevant data. RESULTS: Thirty prospective RCTs were included. Prolonged operative duration, better overall success, neurological success, and NDI success rates were found in ACDR group in all follow-up periods, with lower dysphagia/dysphonia during short-term follow-up. Moreover, a lower ASD was found in ACDR group during long-term follow-up and overall analysis, with lower reoperation rates in all follow-up periods. Comparable length of hospital stay and blood loss were found in both groups. Moreover, ASD was similar in short- and mid-term follow-ups, while dysphagia/dysphonia incidence was similar in mid- and long-term follow-ups. The incidence of implant events was comparable in all follow-up periods (p > 0.05). CONCLUSIONS: ACDR is as effective as ACDF and superior for some success rates. Disc replacement can reduce the risk of dysphagia/dysphonia, ASD, and re-operation.
PURPOSE: Anterior cervical discectomy and fusion (ACDF) surgery is commonly performed to treat cervical degenerative disc disease (CDDD). The lost of range of motion (ROM) is also found after ACDF, which contributes to degenerate in adjacent segment disease (ASD). Artificial cervical disc replacement (ACDR), an alternative to ACDF, is developed to preserve the ROM and reduce ASD. This article aims to compare the outcomes between ACDR and ACDF in the short-, mid-, and long-term. METHODS: Databases including Cochrane, Embase, PubMed, and Web of Science were searched. Only RCTs were included in this meta-analysis, and the search strategy followed the requirements of the Cochrane Handbook. The strength of evidence was assessed using GRADE. Two reviewers independently assessed the methodological quality of each included study and extracted the relevant data. RESULTS: Thirty prospective RCTs were included. Prolonged operative duration, better overall success, neurological success, and NDI success rates were found in ACDR group in all follow-up periods, with lower dysphagia/dysphonia during short-term follow-up. Moreover, a lower ASD was found in ACDR group during long-term follow-up and overall analysis, with lower reoperation rates in all follow-up periods. Comparable length of hospital stay and blood loss were found in both groups. Moreover, ASD was similar in short- and mid-term follow-ups, while dysphagia/dysphonia incidence was similar in mid- and long-term follow-ups. The incidence of implant events was comparable in all follow-up periods (p > 0.05). CONCLUSIONS: ACDR is as effective as ACDF and superior for some success rates. Disc replacement can reduce the risk of dysphagia/dysphonia, ASD, and re-operation.
Authors: Jason C Eck; S Craig Humphreys; Tae-Hong Lim; Soon Tack Jeong; Jesse G Kim; Scott D Hodges; Howard S An Journal: Spine (Phila Pa 1976) Date: 2002-11-15 Impact factor: 3.468
Authors: Domagoj Coric; Richard D Guyer; Pierce D Nunley; David Musante; Cameron Carmody; Charles Gordon; Carl Lauryssen; Margaret O Boltes; Donna D Ohnmeiss Journal: J Neurosurg Spine Date: 2018-01-05
Authors: Lindsay Tetreault; Christina L Goldstein; Paul Arnold; James Harrop; Alan Hilibrand; Aria Nouri; Michael G Fehlings Journal: Neurosurgery Date: 2015-10 Impact factor: 4.654
Authors: Zorica Buser; Darrel S Brodke; Jim A Youssef; Hans-Joerg Meisel; Sue Lynn Myhre; Robin Hashimoto; Jong-Beom Park; S Tim Yoon; Jeffrey C Wang Journal: J Neurosurg Spine Date: 2016-05-27
Authors: Roland D Donk; Wim I M Verhagen; Allard J F Hosman; Andre Verbeek; Ronald H M A Bartels Journal: Clin Spine Surg Date: 2018-02 Impact factor: 1.876
Authors: Kostas N Fountas; Eftychia Z Kapsalaki; Leonidas G Nikolakakos; Hugh F Smisson; Kim W Johnston; Arthur A Grigorian; Gregory P Lee; Joe S Robinson Journal: Spine (Phila Pa 1976) Date: 2007-10-01 Impact factor: 3.468
Authors: Kris Radcliff; Reginald J Davis; Michael S Hisey; Pierce D Nunley; Gregory A Hoffman; Robert J Jackson; Hyun W Bae; Todd Albert; Dom Coric Journal: Int J Spine Surg Date: 2017-11-28
Authors: Ian J Wellington; Cameron Kia; Ergin Coskun; Barrett B Torre; Christopher L Antonacci; Michael R Mancini; John P Connors; Sean M Esmende; Heeren S Makanji Journal: Bioengineering (Basel) Date: 2022-05-23