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Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis

  • Authors:
    • Guo-Sheng Zhao
    • Qiao Zhang
    • Zheng-Xue Quan
  • View Affiliations / Copyright

    Affiliations: Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China, Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
    Copyright: © Zhao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 159-166
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    Published online on: December 2, 2016
       https://doi.org/10.3892/br.2016.823
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Abstract

Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are the most commonly used procedures in cervical spondylosis. However, only a few published studies exist in the literature comparing these two operation types, particularly its mid‑term efficacy and safety. Furthermore, in those studies, even large sample trials, when compared, have elicited controversial results, making it inconvenient for clinicians to refer to them. The aim of the present study was to clarify the advantages and shortcomings of the two procedures. Articles indexed in the PubMed, Web of Science, Cochrane Library, EMBASE, China Biological Medicine and China National Knowledge Infrastructure (CNKI) databases, as of March 2016, that met our criteria were searched. A total of 18 trials involving 3,040 patients were included in our final analysis. The most important results drawn from the present analysis were as follows: Insignificant differences were identified in the blood loss [weighted mean difference (WMD)=6.23; 95% confidence intervals (CI), -0.85 to 13.32; P=0.08], surgical time [standardized mean difference (SMD)=0.40; 95% CI, -0.01 to 0.82; P=0.06], the time of hospital stay (SMD=0.05; 95% CI, -0.28 to 0.37; P=0.77) and the total complications rate [odds ratio (OR)=0.86; 95% CI, 0.66 to 1.13l; P=0.28] on a comparison of the two operation methods. By contrast, comparing CDA with ACDF, the CDA had higher Short Form survey (SF-36) scores (WMD=1.65; 95% CI, 0.61 to 2.69; P=0.002), a larger range of motion in the operation level (SMD=6.53; 95% CI, 3.89 to 9.17; P<0.0001), a higher rate of neurological improvement following the operation (OR=1.80; 95% CI, 1.29 to 2.52; P=0.0006), a lower Visual Analog Scale (VAS) score of neck pain (WMD= 0.16; 95% CI, -0.28 to 0.05; P=0.006) and arm pain (WMD= 0.12; 95% CI, -0.24 to -0.01; P=0.04). In addition, in the mid-term following the surgery, CDA had a lower Neck Disability Index (NDI; SMD=0.18; 95% CI, -0.28 to -0.07; P=0.001) and a lower reoperation rate of adjacent levels (OR=0.54; 95% CI, 0.35 to 0.85; P=0.007) compared with ACDF. Taken together, these results suggested that CDA and ACDF are efficient and safe methods for dealing with cervical spondylosis. However, with respect to certain specific indicators, such as the reoperation rate of adjacent levels following surgery, the former has several advantages.
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1 

Wang C, Tian F, Zhou Y, He W and Cai Z: The incidence of cervical spondylosis decreases with aging in the elderly, and increases with aging in the young and adult population: A hospital based clinical analysis. Clin Interv Aging. 11:47–53. 2016.PubMed/NCBI

2 

Que Q, Ye X, Su Q, Weng Y, Chu J, Mei L, Huang W, Lu R and Zheng G: Effectiveness of acupuncture intervention for neck pain caused by cervical spondylosis: Study protocol for a randomized controlled trial. Trials. 14:1862013. View Article : Google Scholar : PubMed/NCBI

3 

Strine TW and Hootman JM: US national prevalence and correlates of low back and neck pain among adults. Arthritis Rheum. 57:656–665. 2007. View Article : Google Scholar : PubMed/NCBI

4 

Hilibrand AS, Carlson GD, Palumbo MA, Jones PK and Bohlman HH: Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 81:519–528. 1999. View Article : Google Scholar : PubMed/NCBI

5 

Matsumoto M, Okada E, Ichihara D, Watanabe K, Chiba K, Toyama Y, Fujiwara H, Momoshima S, Nishiwaki Y, Iwanami A, et al: Anterior cervical decompression and fusion accelerates adjacent segment degeneration: comparison with asymptomatic volunteers in a ten year magnetic resonance imaging follow-up study. Spine. 35:36–43. 2010. View Article : Google Scholar : PubMed/NCBI

6 

Fernström U: Arthroplasty with intercorporal endoprothesis in herniated disc and in painful disc. Acta Chir Scand Suppl. 357:154–159. 1966.PubMed/NCBI

7 

Leung C, Casey AT, Goffin J, Kehr P, Liebig K, Lind B, Logroscino C and Pointillart V: Clinical significance of heterotopic ossification in cervical disc replacement: A prospective multicenter clinical trial. Neurosurgery. 57:759–763. 2005. View Article : Google Scholar : PubMed/NCBI

8 

Malham GM, Parker RM, Ellis NJ, Chan PG and Varma D: Cervical artificial disc replacement with ProDisc-C: Clinical and radiographic outcomes with long-term follow-up. J Clin Neurosci. 21:949–953. 2014. View Article : Google Scholar : PubMed/NCBI

9 

Sasso RC, Anderson PA, Riew KD and Heller JG: Results of cervical arthroplasty compared with anterior discectomy and fusion: Four-year clinical outcomes in a prospective, randomized controlled trial. Orthopedics. 34:8892011. View Article : Google Scholar : PubMed/NCBI

10 

Burkus JK, Haid RW, Traynelis VC and Mummaneni PV: 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. 13:308–318. 2010. View Article : Google Scholar : PubMed/NCBI

11 

Lau J, Ioannidis JP and Schmid CH: Quantitative synthesis in systematic reviews. Annals of internal medicine. 127:820–826. 1997. View Article : Google Scholar : PubMed/NCBI

12 

Begg CB and Mazumdar M: Operating characteristics of a rank correlation test for publication bias. Biometrics. 50:1088–1101. 1994. View Article : Google Scholar : PubMed/NCBI

13 

Sterne JA, Egger M and Smith GD: Systematic reviews in health care: Investigating and dealing with publication and other biases in meta analysis. BMJ. 323:101–105. 2001. View Article : Google Scholar : PubMed/NCBI

14 

Copas J and Shi JQ: Meta analysis, funnel plots and sensitivity analysis. Biostatistics. 1:247–262. 2000. View Article : Google Scholar : PubMed/NCBI

15 

Leimu R and Koricheva J: Cumulative meta analysis: A new tool for detection of temporal trends and publication bias in ecology. Proc Biol Sci. 271:1961–1966. 2004. View Article : Google Scholar : PubMed/NCBI

16 

Coric D, Kim PK, Clemente JD, Boltes MO, Nussbaum M and James S: 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. 18:36–42. 2013. View Article : Google Scholar : PubMed/NCBI

17 

Delamarter RB, Murrey D, Janssen ME, et al: Results at 24 months from the prospective, randomized, multicenter Investigational Device Exemption trial of ProDisc C versus anterior cervical discectomy and fusion with 4 year follow-up and continued access patients. SAS journal. 4:122–128. 2010. View Article : Google Scholar : PubMed/NCBI

18 

Garrido BJ, Taha TA and Sasso RC: Clinical outcomes of Bryan cervical disc arthroplasty a prospective, randomized, controlled, single site trial with 48 month follow-up. J Spinal Disord Tech. 23:367–371. 2010. View Article : Google Scholar : PubMed/NCBI

19 

Zigler JE, Delamarter R, Murrey D, Spivak J and Janssen M: ProDisc C and anterior cervical discectomy and fusion as surgical treatment for single level cervical symptomatic degenerative disc disease: five year results of a Food and Drug Administration study. Spine. 38:203–209. 2013. View Article : Google Scholar : PubMed/NCBI

20 

Murrey D, Janssen M, Delamarter R, et al: 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. 9:275–286. 2009. View Article : Google Scholar : PubMed/NCBI

21 

Sasso RC, Smucker JD, Hacker RJ and Heller JG: Clinical outcomes of BRYAN cervical disc arthroplasty: a prospective, randomized, controlled, multicenter trial with 24 month follow-up. J Spinal Disord Tech. 20:481–491. 2007. View Article : Google Scholar : PubMed/NCBI

22 

Nabhan A, Ahlhelm F, Shariat K, et al: The ProDisc C prosthesis: clinical and radiological experience 1 year after surgery. Spine. 32:1935–1941. 2007. View Article : Google Scholar : PubMed/NCBI

23 

Zhang HX, Shao YD, Chen Y, et al: A prospective, randomised, controlled multicentre study comparing cervical disc replacement with anterior cervical decompression and fusion. Int Orthop. 38:2533–2541. 2014. View Article : Google Scholar : PubMed/NCBI

24 

Zhang X, Zhang Y and Xiao S: Medium and long term result of the single level cervical disc arthroplasty for cervical spondylosis meylopathy. Zhongguo Ji Zhu Ji Sui Za Zhi. 22:879–883. 2012.(In Chinese).

25 

Zhang X, Chen C, Zhang Y, et al: Randomized, controlled, multicenter, clinical trial comparing BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion in China. Spine. 37:433–438. 2012. View Article : Google Scholar : PubMed/NCBI

26 

Wang Y, Cai B, Zhang XS, et al: Clinical outcomes of single level Bryan cervical disc arthroplasty: A prospective controlled study. Zhonghua Wai Ke Za Zhi. 46:328–0332. 2008.(In Chinese). PubMed/NCBI

27 

Riina J, Patel A, Dietz JW, Hoskins JS, Trammell TR and Schwartz DD: Comparison of single level cervical fusion and a metal on metal cervical disc replacement device. Am J Orthop (Belle Mead NJ). 37:E71–E77. 2008.PubMed/NCBI

28 

Phillips FM, Allen TR, Regan JJ, et al: Cervical disc replacement in patients with and without previous adjacent level fusion surgery: A prospective study. Spine. 34:556–565. 2009. View Article : Google Scholar : PubMed/NCBI

29 

Peng-Fei S and Yu-Hua J: Cervical disc prosthesis replacement and interbody fusion: A comparative study. Int Orthop. 32:103–106. 2008. View Article : Google Scholar : PubMed/NCBI

30 

Heller JG, Sasso RC, Papadopoulos SM, et al: Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial. Spine. 34:101–107. 2009. View Article : Google Scholar : PubMed/NCBI

31 

Kim SW, Limson MA, Kim SB, Arbatin JJ, Chang KY, Park MS, Shin JH and Ju YS: Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J. 18:218–231. 2009. View Article : Google Scholar : PubMed/NCBI

32 

Goffin J, Geusens E, Vantomme N, Quintens E, Waerzeggers Y, Depreitere B, Van Calenbergh F and van Loon J: Long term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech. 17:79–85. 2004. View Article : Google Scholar : PubMed/NCBI

33 

Porchet F and Metcalf NH: Clinical outcomes with the Prestige II cervical disc: Preliminary results from a prospective randomized clinical trial. Neurosurg Focus. 17:E62004. View Article : Google Scholar : PubMed/NCBI

34 

Gao Y, Liu M, Li T, Huang F, Tang T and Xiang Z: A meta-analysis comparing the results of cervical disc arthroplasty with anterior cervical discectomy and fusion (ACDF) for the treatment of symptomatic cervical disc disease. J Bone Joint Surg Am. 95:555–561. 2013. View Article : Google Scholar : PubMed/NCBI

35 

Yin S, Yu X, Zhou S, Yin Z and Qiu Y: Is cervical disc arthroplasty superior to fusion for treatment of symptomatic cervical disc disease? A meta analysis. Clin Orthop Relat Res. 471:1904–1919. 2013. View Article : Google Scholar : PubMed/NCBI

36 

Zhang Y, Liang C, Tao Y, Zhou X, Li H, Li F and Chen Q: Cervical total disc replacement is superior to anterior cervical decompression and fusion: A meta-analysis of prospective randomized controlled trials. PLoS One. 10:e01178262015. View Article : Google Scholar : PubMed/NCBI

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Copy and paste a formatted citation
Spandidos Publications style
Zhao G, Zhang Q and Quan Z: Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis. Biomed Rep 6: 159-166, 2017.
APA
Zhao, G., Zhang, Q., & Quan, Z. (2017). Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis. Biomedical Reports, 6, 159-166. https://doi.org/10.3892/br.2016.823
MLA
Zhao, G., Zhang, Q., Quan, Z."Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis". Biomedical Reports 6.2 (2017): 159-166.
Chicago
Zhao, G., Zhang, Q., Quan, Z."Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis". Biomedical Reports 6, no. 2 (2017): 159-166. https://doi.org/10.3892/br.2016.823
Copy and paste a formatted citation
x
Spandidos Publications style
Zhao G, Zhang Q and Quan Z: Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis. Biomed Rep 6: 159-166, 2017.
APA
Zhao, G., Zhang, Q., & Quan, Z. (2017). Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis. Biomedical Reports, 6, 159-166. https://doi.org/10.3892/br.2016.823
MLA
Zhao, G., Zhang, Q., Quan, Z."Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis". Biomedical Reports 6.2 (2017): 159-166.
Chicago
Zhao, G., Zhang, Q., Quan, Z."Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis". Biomedical Reports 6, no. 2 (2017): 159-166. https://doi.org/10.3892/br.2016.823
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