P215. Ten-year outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion: a systematic review with meta-analysis

• Published in: The spine journal Vol. 24; no. 9; p. S170
• Main Authors: Quinto, Ernesto S., Paisner, Noah, Huish, Eric G., Senegor, Moris
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.09.2024
• ISSN: 1529-9430
• DOI: 10.1016/j.spinee.2024.06.338

Cervical degenerative disc disease (CDDD) is a common cause of radiculopathy and myelopathy which can result in significant disability. Anterior cervical discectomy and fusion (ACDF) is the gold standard for the treatment of CDDD. However, the loss of motion at the operative level may accelerate adjacent segment disease. The preservation of motion with cervical disc arthroplasty (CDA) attempts to prevent this complication of cervical fusion. Short-term and mid-term data reveal comparable results for CDA versus ACDF; however, long-term results are unknown. The purpose of this study is to compare the 10-year outcomes of cervical disc arthroplasty with those of anterior cervical discectomy and fusion for the treatment of cervical degenerative disc disease. This is a systematic review with meta-analysis of randomized controlled trials and comparative retrospective cohort studies. This study includes 926 patients across six studies who underwent treatment for one-level or two-level cervical degenerative disc disease; 498 patients underwent cervical disc arthroplasty and 428 patients underwent anterior cervical discectomy and fusion. Primary outcome measures included neck disability index (NDI) score and visual analogue scale (VAS) pain score. Secondary outcome measures included Japanese Orthopaedic Association (JOA) score, percent neurological success, secondary surgeries, and adverse events. A systematic review with meta-analysis was performed to determine if CDA had improved outcomes compared with ACDF at 10-year follow-up. PubMed and Web of Science database searches from January 2012 through August 2023 were performed to identify randomized controlled trials and comparative retrospective cohort studies involving treatment of one-level or two-level CDDD. Six studies were eligible for analysis. CDA had significantly improved NDI and VAS scores but lower JOA scores compared to ACDF at 10-year follow-up (P < 0.05). However, none of these results met minimal clinically important differences. CDA had significantly fewer secondary surgeries and adverse events compared to ACDF (P < 0.05). There were no significant differences in neurological success. The authors found that significantly fewer secondary surgeries and adverse events were seen after CDA than after ACDF at 10-year follow-up. CDA had statistically, but not clinically, improved neck disability index and visual analog scale scores but lower Japanese Orthopaedic Association scores in comparison to ACDF. CDA was not significantly different from ACDF in terms of a successful neurological outcome. This abstract does not discuss or include any applicable devices or drugs.