CORR Insights^®: Reoperation After Cervical Disc Arthroplasty Versus Anterior Cervical Discectomy and Fusion: A Meta-analysis

Excerpt

Is there a higher reoperation rate after anterior cervical discectomy and fusion when compared to cervical disc replacement? This is a common question asked by spinal surgeons determining the best intervention for patients with cervical radiculopathy due to soft-disc herniation or minor spondylosis. Generally, spine surgeons indicate a patient for cervical disc replacement if there is only one level of disease or, at most, two levels assuming there is minimal to no spondylosis. It is also thought (and hoped) that cervical disc replacement would lessen the rate of adjacent segment disease and the need for reoperation. A meta-analysis can help detemine whether this aspiration will come to fruition. A number of intermediate-term trials [5‐10] have suggested an increased rate of reoperation and poor health-related quality of life outcomes with anterior cervical discectomy and fusion when compared to cervical disc replacement. However, these findings have not been consistent. Some studies show no difference between anterior cervical discectomy and fusion and cervical disc replacement, while others demonstrate superiority of cervical disc replacement [2, 4, 5]. …