Single-center results at 7 years of prospective, randomized ProDisc-C total disc arthroplasty versus anterior cervical discectomy and fusion for treatment of one level symptomatic cervical disc disease

Kesman, Thomas J.; Murrey, Daniel B.; Darden, Bruce V.

doi:10.1055/s-0032-1328144

Cited by 5 publications

(3 citation statements)

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“…They used single-site data which is part of a multicenter trial or missed some important data. In the same time, many randomized controlled trials (RCTs) comparing CDA with ACDF for the treatment of CDDDs were performed (Burkus et al 2010 , 2014 ; Cheng et al 2009 , 2011 ; Coric et al 2011 ; Davis et al 2013 ; Delamarter and Zigler 2013 ; Delamarter et al 2010 ; Davis et al 2015 ; Hisey et al 2014 , 2015 ; Heller et al 2009 ; Kesman et al 2012 ; Kelly et al 2011 ; McAfee et al 2010 ; Mummaneni et al 2007 ; Murrey et al 2008 , 2009 ; Phillips et al 2013 , 2015 ; Nabhan et al 2007a , b , c , 2011 ; Porchet and Metcalf 2004 ; Qizhi et al 2014 ; Riina et al 2008 ; Riew et al 2008 ; Rozankovic et al 2014 ; Sasso et al 2007 , 2008 , 2011 ; Skeppholm et al 2015 ; Vaccaro et al 2013 ; Zhang et al 2012 , 2014 ; Zigler et al 2013 ). Therefore, an updated meta-analysis is needed which is based on the latest high quality studies.…”

Section: Introductionmentioning

confidence: 99%

Cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) in symptomatic cervical degenerative disc diseases (CDDDs): an updated meta-analysis of prospective randomized controlled trials (RCTs)

et al. 2016

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PurposeThis meta-analysis of randomized controlled trials (RCTs) aims to evaluate the efficacy and safety in cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) for treating cervical degenerative disc diseases (CDDDs).MethodsThe authors searched RCTs in the electronic databases (Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Medline, Embase, Springer Link, Web of Knowledge, OVID and Google Scholar) from their establishment to march 2016 without language restrictions. We also manually searched the reference lists of articles and reviews for possible relevant studies. Researches on CDA versus ACDF in CDDDs were selected in this meta-analysis. The quality of all studies was assessed and effective data was pooled for this meta-analysis. Outcome measurements were surgical parameters (operative time, blood loss, and length of hospital stay), clinical indexes [neck disability index (NDI), neurological success, range of motion (ROM), Visual Analogue Score (VAS)], complications [the number of adverse events, adjacent segment disease (ASD), and reoperation]. Subgroup analysis, sensitivity analysis, and publication bias assessment were also performed, respectively. The meta-analysis was performed with software revman 5.3.Results37 articles (20 RCTs) with a total 4004 patients (2212 in the CDA and 1792 in the ACDF) met inclusion criteria. Eight types of disc prostheses were used in the included studies. Patients were followed up for at least 2 years in all the studies. No statistically significant differences were found between CDA and ACDF for blood loss [SMD −0.02; 95 % CI (−0.20, 0.17)], length of hospital stay [MD −0.06; 95 % CI (−0.19, 0.06)]. Statistical differences were found between operative time [MD 14.22; 95 % CI (6.73, 21.71)], NDI [SMD −0.27; 95 % CI (−0.43, −0.10)], neurological success [RR 1.13; 95 % CI (1.08, 1.18)], ROM [MD 6.72; 95 % CI (5.72, 7.71)], VAS of neck [SMD −0.40; 95 % CI (−0.75, −0.04)], VAS of arm [SMD −0.55; 95 % CI (−1.04, −0.06)], the rate of adverse events [RR 0.72 95 % CI (0.53, 0.96)], the rate of ASD [RR 0.62; 95 % CI (0.43, 0.88)], and reoperation [RR 0.50; 95 % CI (0.39, 0.63)]. Subgroup analysis stratified by different types of disc prostheses was also performed.ConclusionsCDA is associated with higher clinical indexes and fewer complications than ACDF, indicating that it is a safe and effective treatment for CDDDs. However, the operative time of CDA is longer than ACDF. Because of some limitations, these findings should be interpreted with caution. Additional studies are needed. Large, definitive RCTs are needed.

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Section: Introductionmentioning

confidence: 99%

Cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) in symptomatic cervical degenerative disc diseases (CDDDs): an updated meta-analysis of prospective randomized controlled trials (RCTs)

et al. 2016

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“…To date there have been several published reports of randomized controlled trials comparing ACDF with AD replacement with varying results. 4,21,35,48,64,70,71 The results of these trials have shown that AD replacement has excellent outcomes and in some instances is superior to ACDF with lower reoperation rates as well as improved clinical outcomes. Biomechanical studies are important to better understand neck function postsurgery and may provide insight into the mechanical factors that contribute to a good or poor clinical outcome.…”

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confidence: 99%

Three-dimensional motion analysis of the cervical spine for comparison of anterior cervical decompression and fusion versus artificial disc replacement in 17 patients

McDonald¹,

Chang

McDonald³

et al. 2014

SPI

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Object Cervical arthroplasty with an artificial disc (AD) has emerged as an alternative to anterior cervical discectomy and fusion (ACDF) for the management of cervical spondylosis. This study aims to provide 3D motion analysis data comparing patients after ACDF and AD replacement. Methods Ten patients who underwent C5–6 ACDF and 7 who underwent C5–6 AD replacement were enrolled. Using biplanar fluoroscopy and a model-based track technique (accurate up to 0.6 mm and 0.6°), motion analysis of axial rotation and flexion-extension of the neck was performed. Three nonoperative segments (C3–4, C4–5, and C6–7) were assessed for both intervertebral rotation (coronal, sagittal, and axial planes) and facet shear (anteroposterior and mediolateral). Results There was no difference in total neck motion comparing ACDF and AD replacement for neck extension (43.3° ± 10.2° vs 44.3° ± 12.6°, p = 0.866) and rotation (36.0° ± 6.5° vs 38.2° ± 9.3°, p = 0.576). For extension, when measured as a percentage of total neck motion, there was a greater amount of rotation at the nonoperated segments in the ACDF group than in the AD group (p = 0.003). When comparing specific motion segments, greater normalized rotation was seen in the ACDF group at C3–4 (33.2% ± 4.9% vs 26.8% ± 6.6%, p = 0.036) and C6–7 (28.5% ± 6.7% vs 20.5% ± 5.5%, p = 0.009) but not at C4–5 (33.5% ± 6.4% vs 31.8% ± 4.0%, p = 0.562). For neck rotation, greater rotation was observed at the nonoperative segments in the ACDF group than in the AD group (p = 0.024), but the differences between individual segments did not reach significance (p ≥ 0.146). Increased mediolateral facet shear was seen on neck extension with ACDF versus AD replacement (p = 0.008). Comparing each segment, C3–4 (0.9 ± 0.5 mm vs 0.4 ± 0.1 mm, p = 0.039) and C4–5 (1.0 ± 0.4 mm vs 0.5 ± 0.2 mm, p = 0.022) showed increased shear while C6–7 (1.0 ± 0.4 mm vs 1.0 ± 0.5 mm, p = 0.767) did not. Conclusions This study illustrates increased motion at nonoperative segments in patients who have undergone ACDF compared with those who have undergone AD replacement. Further studies will be required to examine whether these changes contribute to adjacent-segment disease.

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“…44 Murrey et al (200844 Murrey et al ( , 2009, Delamarter et al (2010), Kelly et al (2011), Kesman et al (2012), Zigler et al (2013), Zigler et al (2013)[48][49][50][51][52][53][54] …”

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confidence: 99%

Anterior approach to the cervical spine: Elegance lies in its simplicity

Arumalla

Bansal

Jadeja³

et al. 2021

Asian J Neurosurg

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Introduction: Since the landmark publication by Smith and Robinson, approaches to the cervical spine anteriorly have undergone many modifications and even additions. Nevertheless, at its core, the anterior approach remains an elegant and efficient approach to deal with majority of cervical spine pathologies including the degenerative cervical spine. Methodology: For this review, we searched for all major cases series and randomized control trials of anterior cervical approaches using the PubMed databases. Articles having the details of clinical variables and outcomes were tabulated and analyzed. Results: A total of 9 case series for transoral, 7 case series for transmanubrial, 19 case series for anterior cervical discectomy and fusion (ACDF), 6 studies for ACDF versus posterior cervical foraminotomy, 37 case series for ACDF versus arthroplasty, and 7 studies for ACDF versus anterior cervical corpectomy and fusion have been included. The majority of the case series suggested that the anterior cervical procedures have good clinical outcomes. The upper cervical spine approached by the transoral route had good outcomes in ventral compressive pathologies, with morbidity of cerebrospinal fluid leak in 7% of patients. The midcervical spine approached by ACDF had better clinical outcomes equivalent to the majority of modifications even in multiple-level pathologies. The transsternal approach had provided greater access and stability to the cervicothoracic junction with minimal morbidity. Conclusion: The anterior cervical approach can address the majority of cervical pathologies. They provide adequate corridor from craniovertebral junction to T4 with minimal morbidity, thus providing a good clinical outcome.

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Single-center results at 7 years of prospective, randomized ProDisc-C total disc arthroplasty versus anterior cervical discectomy and fusion for treatment of one level symptomatic cervical disc disease

Cited by 5 publications

References 1 publication

Cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) in symptomatic cervical degenerative disc diseases (CDDDs): an updated meta-analysis of prospective randomized controlled trials (RCTs)

Cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) in symptomatic cervical degenerative disc diseases (CDDDs): an updated meta-analysis of prospective randomized controlled trials (RCTs)

Three-dimensional motion analysis of the cervical spine for comparison of anterior cervical decompression and fusion versus artificial disc replacement in 17 patients

Anterior approach to the cervical spine: Elegance lies in its simplicity

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