Secondary Surgery after Cervical Disc Arthroplasty versus Fusion for Cervical Degenerative Disc Disease: A Meta-analysis with Trial Sequential Analysis

Orthopaedic Surgery
Ru-Sen ZhuWei Hu

Abstract

The purpose of this meta-analysis was to explore whether cervical disc arthroplasty (CDA) was superior to anterior cervical discectomy and fusion (ACDF) in reducing secondary surgery. PubMed, EMBASE, and the Cochrane Library databases were systematically searched. Outcomes were reported as relative risk (RR) with the corresponding 95% confidence interval (CI). The pooled data was calculated using a random-effect model. We also used the trial sequential analysis (TSA) to further verify our results and obtain more moderate estimates. Twenty-one studies with 4208 patients were included in this meta-analysis. The results indicated that compared with ACDF, CDA had fewer frequency of secondary surgery at the index level (RR, 0.47; 95%CI, 0.36-0.63; P < 0.05) and adjacent level (RR, 0.48; 95%CI, 0.36-0.65; P < 0.05), and the differences were statistically significant. In addition, in terms of the overall frequency of secondary surgery at the index and adjacent level, CDA was also significantly superior to ACDF (RR, 0.49; 95%CI, 0.41-0.60; P < 0.05). TSA demonstrated that adequate and decisive evidence had been established. Regarding the frequency of secondary surgery, CDA was significantly superior to ACDF. It was supposed that CDA ma...Continue Reading

References

Jun 14, 2005·The Orthopedic Clinics of North America·Rudolf BertagnoliSandra Voigt
Dec 18, 2007·Journal of Clinical Epidemiology·Jørn WetterslevChristian Gluud
Feb 12, 2014·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Chunpeng RenXi Yang
Apr 8, 2014·The Spine Journal : Official Journal of the North American Spine Society·Sreeharsha V NandyalaKern Singh
Dec 10, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Jia LiYong Shen
Mar 4, 2015·The Spine Journal : Official Journal of the North American Spine Society·Martin SkeppholmClaes Olerud
Feb 3, 2016·Clinical Orthopaedics and Related Research·Zhao-Ming ZhongJian-Ting Chen
Feb 13, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Thomas P LoumeauDaniel B Murrey
Dec 25, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jarle SundsethUNKNOWN NORCAT study group

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Citations

Apr 12, 2020·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jack E ZiglerDonna D Ohnmeiss

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