Orthopädie und Muskulatur: Aktuelle Forschung
Offener Zugang
ISSN: 2161-0533
ISSN: 2161-0533
Young Lu, Andrew C Hecht, Samuel Cho and Sheeraz Qureshi
Anterior Cervical Discectomy and Fusion (ACDF) is a widely utilized surgical treatment for cervical disc disease.
Despite success of ACDF, concerns regarding adjacent segment degeneration led to the design and development
of cervical disc arthroplasty (CDA). We performed a systematic review of studies comparing the efficacy and safety
profile of CDA versus ACDF. We searched databases Pubmed, EMBASE and Cochrane Central Register of Controlled
Trials (CENTRAL) for prospective randomized controlled studies comparing CDA with ACDF with at least 24-month
follow-up. Studies were evaluated for level of bias. Data regarding clinical outcomes, postoperative kinematic changes,
procedure or device related adverse events and types and rates of secondary surgeries were extracted. A total of 142
articles were retrieved of which 8 articles satisfied the inclusion and exclusion criteria. These eight studies cover five
different disc devices (BRYAN, PRESTIGE, ProDisc-C, Kineflex|C and Porous Coated Motion). There are significant
differences in some patient reported clinical outcomes favoring arthroplasty over ACDF. Arthroplasty also preserved
motion at the operated site while fusion reduced range of motion at the fused segments. The type and rate of adverse
events, postoperative complications and secondary surgeries are similar between the two groups. The rate of surgeries
for adjacent level degeneration is similar between CDA and ACDF. Cervical Disc Arthroplasty is a viable alternative
procedure in the surgical management of cervical disc disease with similar safety profiles and at least equivalent and
possibly superior clinical outcomes compared to Anterior Cervical Discectomy and Fusion. There does not appear to
be significant differences in reoperation rates for adjacent level degeneration between the two procedure types. Future
long-term follow up studies are needed to make a more robust conclusion on the overall effectiveness of CDA.