NDLI: Mid- to long-term rates of symptomatic adjacent-level disease requiring surgery after cervical total disc replacement compared with anterior cervical discectomy and fusion: a meta-analysis of prospective randomized clinical trials

Content Provider	Springer Nature : BioMed Central
Author	Deng, Yifei Li, Guangzhou Liu, Hao Hong, Ying Meng, Yang
Abstract	Background Thus far, no meta-analysis focusing on the mid- to long-term incidence of adjacent segment disease requiring surgery after cervical total disc replacement and anterior cervical discectomy and fusion has been published yet. This study aimed to compare mid- to long-term rates of symptomatic adjacent-level disease requiring surgery after cervical disc replacement and anterior cervical fusion. Methods A meta-analysis was performed, and only randomized controlled trials with a follow-up period of more than 48 months reporting rates of symptomatic adjacent-level disease requiring surgery after cervical total disc replacement and anterior cervical discectomy and fusion were included. Results The analysis revealed that the overall rate of symptomatic adjacent-level disease requiring surgery in the cervical disc replacement group was significantly lower than that of the anterior cervical fusion group at 48–120 months’ follow-up. The subgroup analysis of different follow-up periods also yielded the same results. The rate of symptomatic adjacent-level disease requiring surgery in the cervical disc replacement group using unrestricted prosthesis was significantly lower than that of the anterior cervical fusion group (p < 0.001); however, the cervical disc replacement group using semi-restricted prosthesis showed no statistical difference compared with the fusion group. Conclusions Our review suggests that cervical disc replacement is preferable to anterior cervical fusion in reducing the incidence of symptomatic adjacent-level disease requiring surgery at mid- to long-term follow-up. A review of the literature also demonstrated that randomized controlled trials investigating the rate of symptomatic adjacent-level disease requiring surgery were insufficient; therefore, studies focusing on this subject with longer-term follow-up are warranted.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-020-01957-3.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-020-01957-3
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	15
Language	English
Publisher	BioMed Central
Publisher Date	2020-10-12
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Adjacent segment disease Cervical total disc replacement Anterior cervical discectomy and fusion
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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