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Anterior cervical discectomy and fusion versus cervical arthroplasty for the management of cervical spondylosis: a meta-analysis

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Abstract

Purpose

The aim of this study was to compare the efficacy and safety of anterior cervical discectomy and fusion (ACDF) and cervical arthroplasty for patients with cervical spondylosis.

Methods

PubMed, Embase, and Cochrane Library were used to search for relevant articles published prior to April 2016 to identify studies comparing ACDF and cervical arthroplasty involving patients with cervical spondylosis. Relative risks (RR) and mean differences (MD) were used to measure the efficacy and safety of ACDF and cervical arthroplasty using the random effects model.

Results

The meta-analysis of 17 studies involved 3122 patients diagnosed with cervical spondylosis. Patients undergoing ACDF showed lower overall success rate (RR 0.84; 95 % CI 0.77–0.92; P < 0.001), higher VAS score (MD 0.36; 95 % CI 0.08–0.64; P = 0.011), and shorter mean surgical duration (MD −1.62; 95 % CI −2.80 to −0.44; P = 0.007) when compared with cervical arthroplasty. However, the association between ACDF therapy and the risk of mean blood loss (MD −0.16; 95 % CI −0.34 to 0.02; P = 0.082), mean hospitalization (MD 0.02; 95 % CI −0.31 to 0.36; P = 0.901), patient satisfaction (RR 0.96; 95 % CI 0.92–1.00; P = 0.066), neck disability index (MD 0.20; 95 % CI −0.05 to 0.44; P = 0.113), reoperation (RR 1.25; 95 % CI 0.64–2.41; P = 0.514), or complication (RR 1.17; 95 % CI 0.90–1.52; P = 0.242) was not statistically significant.

Conclusions

Patients undergoing ACDF therapy tended to exhibit lower overall success rate, higher VAS score, and decreased mean surgical duration when compared with patients treated with cervical arthroplasty.

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    Authors and Affiliations

    1. Department of Orthopaedics, Shanxi Academy of Medical Sciences & Shanxi DaYi Hospital, No. 99 Long Cheng Street, Taiyuan, 030032, Shanxi Province, China

      Zhuo Ma, Xun Ma & Xiaoming Guan

    2. Department of Orthopaedics, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou, 215000, Jiangsu Province, China

      Zhuo Ma & Huilin Yang

    3. Department of Orthopaedics, Huai’an First People’s Hospital, Nanjing Medical University, Huai’an, 223300, Jiangsu Province, China

      Xiang Li

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    1. Zhuo Ma
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    Correspondence to Huilin Yang.

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    Z. Ma and X. Ma contributed equally to this work.

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    Ma, Z., Ma, X., Yang, H. et al. Anterior cervical discectomy and fusion versus cervical arthroplasty for the management of cervical spondylosis: a meta-analysis. Eur Spine J 26, 998–1008 (2017). https://doi.org/10.1007/s00586-016-4779-7

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