Efficacy Of Cervical Disc Arthroplasty Versus Anterior Cervical Decompression And Fusion For Single-level Cervical Disc Disease:A Meta-Analysis

Objective:To assess the effect of cervical disc replacement versus anterior cervical discectomy and fusion (ACDF) in treating cervical radiculopathy or myelopathy with a meta-analysis. Methods:A computer-based online search of Medline (1980/2013-12), Embase(1980/2013-12), OVID(1980/2013-12),CBM (2013-12) and CNKI (2013-12), medalink, as well as Cochrane library were performed to collect randomized controlled trials of cervical disc replacement versus ACDF. Data were evaluated by RevMan5.2.7for Meta analysis. Results:A total of25studies were included, The results of Meta-analysis indicates that:(1) There are no statistical differences were found in the mean operation time,mean blood loss, mean hospital stay and complication rate between cervical disc replacement group and ACDF group. The reoperation rate of the disc replacement group was lower than ACDF group in two years postoperative.(2) There are no statistical differences in satisfaction rate between two groups, and the neck disability index (NDI), visual analog scale (VAS), shortform-36(SF-36) scores were significantly improving more in disc replacement group than in ACDF group postoperative.(3) In disc replacement group, the rang of motion of the target level were protected well postoperative, and less effects on the quality of motion at adjacent levels was found compaired with the ACDF group. Conclusion:The procedure of cervical disc replacement is safty as anterior cervical discectomy and fusion, disc replacement group has more good performance in cervical function indexes and quality of motion at target level and adjacent segment than ACDF group, However, there may be bias, more randomized controlled trials are required.