Mid- and long-term outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion for single-level cervical spondylosis: a meta-analysis / 中国组织工程研究

ABSTRACT

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is the gold standard for degenerative cervical disease,which would be replaced by cervical disc arthroplasty (CDA) with the wide application of CDA. But, the mid- and long-term outcomes of ACDF versus CDA remain controversial.OBJECTIVE: To compare the mid- and long-term outcomes of ACDF and CDA in the treatment of single-level cervical spondylosis.METHODS: PubMed, Medline, EMbase, Cochrane, CBM, CNKI, VIP and WanFang databases were searched for randomized controlled trials addressing CDA versus ACDF for single-level cervical spondylosis published before August 2016. The quality of trails was strictly evaluated, the data were extracted and a meta-analysis was performed on ReviewManager5.3 software.RESULTS AND CONCLUSION: (1) Totally 15 randomized controlled trials involving 2781 patients were included, with 4-10 years of follow-up. (2) Meta-analysis results showed that compared with ACDF, CDA had better SF-36 scores,larger range of motion at operation level, lower the Neck Disability Index, and Visual Analogue Scale scores for arm pain,lower reoperation rate at operation level and adjacent level at mid- and long-term follow-up. (3) The Visual Analogue Scale scores for neck pain, neurologic success and all-complication rate did not differ significantly between two groups.(4) These results manifest that CDA is superior to ACDF in the mid- and long-term outcomes for single-level cervical spondylosis; however, further large-scale, multi-center and high-quality randomized controlled trials will be necessary.