Abstract:

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a gold standard to treat degenerative cervical syndrome. However, with the increasing application and follow-up data of ACDF, its adverse effects have been shown. In the past 20 years, artificial cervical disc replacement has been widely used in clinic, and the therapeutic effect is favorable.
OBJECTIVE: To assess the effect of cervical disc replacement versus ACDF for cervical radiculopathy or myelopathy.
METHODS: A computer-based online search of Medline (1966/2009-06), Embase (1966/2009-06), CBM (2009-06) and CNKI (2009-06), as well as Cochrane Back Group, and Cochrane library were performed to collect randomized controlled trials of cervical disc replacement versus ACDF. Data were evaluated by RevMan4.2.2 for Meta analysis.
RESULTS AND CONCLUSION: A total of 15 studies were included. Meta-analysis indicates that no differences were found in the mean operation time, mean blood loss, mean hospital stay, satisfaction rate, and complication between two groups; the reoperation rate of the disc replacement group was lower than ACDF group in two years postoperation; disc replacement group was more efficient in improving cervical function indexes than ACDF group, and the postoperative SF-36 scores were significantly more than ACDF group. Moreover, postoperative motion range of affected segment was significantly greater in the disc replacement group than the ACDF, and the motion rage of adjacent segment was significantly increased in patients underwent ACDF compared with disc replacement treatment. However, there may be bias, more randomized controlled trials are required.