Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease

Abstract Anterior cervical discectomy and fusion (ACDF) and total cervical disc replacement (TDR) are considered effective treatments for patients with cervical degenerative disc disease (CDDD). An indirect meta-analysis including 19 randomized controlled trials (5343 patients) was conducted to comp...

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Autores principales:	Bin Xu, Jian-xiong Ma, Jin-hui Tian, Long Ge, Xin-long Ma
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/52bd499cfe6b478295a3600f96b5bcdd
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spelling	oai:doaj.org-article:52bd499cfe6b478295a3600f96b5bcdd2021-12-02T15:06:23ZIndirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease10.1038/s41598-017-01865-32045-2322https://doaj.org/article/52bd499cfe6b478295a3600f96b5bcdd2017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-01865-3https://doaj.org/toc/2045-2322Abstract Anterior cervical discectomy and fusion (ACDF) and total cervical disc replacement (TDR) are considered effective treatments for patients with cervical degenerative disc disease (CDDD). An indirect meta-analysis including 19 randomized controlled trials (5343 patients) was conducted to compare the clinical outcomes of ACDF with TDR. Primary outcomes including functional indicators (NDI [neck disability index] score, neurological success and patient satisfaction), secondary outcomes including surgical outcomes (operation time, blood loss and length of stay) and secondary surgical procedures (secondary surgery at an adjacent level, secondary surgery at the index level, secondary surgery at both levels, removal, reoperation, revision and supplemental fixation) were included in the study. TDR using the Bryan disc was associated with a greater improvement in NDI score than ACDF (MD = −5.574, 95% CrIs [credible intervals] −11.73–−0.219). For neurological success, the Bryan (odds ratio [OR] = 0.559, 95% CrIs 0.323–0.955) and Prestige (OR = 0.474, 95% CrIs 0.319–0.700) discs were superior to ACDF. However, no differences in the patient satisfaction rate were shown between TDR and ACDF. For patients with CDDD, ACDF using allograft and a plate is most effective for determining the surgical parameters. Moreover, TDR using the ProDisc-C, Mobi-C, Prestige and Bryan discs are good choices for improving functional outcomes and reducing secondary surgeries.Bin XuJian-xiong MaJin-hui TianLong GeXin-long MaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-10 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Bin Xu Jian-xiong Ma Jin-hui Tian Long Ge Xin-long Ma Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease
description	Abstract Anterior cervical discectomy and fusion (ACDF) and total cervical disc replacement (TDR) are considered effective treatments for patients with cervical degenerative disc disease (CDDD). An indirect meta-analysis including 19 randomized controlled trials (5343 patients) was conducted to compare the clinical outcomes of ACDF with TDR. Primary outcomes including functional indicators (NDI [neck disability index] score, neurological success and patient satisfaction), secondary outcomes including surgical outcomes (operation time, blood loss and length of stay) and secondary surgical procedures (secondary surgery at an adjacent level, secondary surgery at the index level, secondary surgery at both levels, removal, reoperation, revision and supplemental fixation) were included in the study. TDR using the Bryan disc was associated with a greater improvement in NDI score than ACDF (MD = −5.574, 95% CrIs [credible intervals] −11.73–−0.219). For neurological success, the Bryan (odds ratio [OR] = 0.559, 95% CrIs 0.323–0.955) and Prestige (OR = 0.474, 95% CrIs 0.319–0.700) discs were superior to ACDF. However, no differences in the patient satisfaction rate were shown between TDR and ACDF. For patients with CDDD, ACDF using allograft and a plate is most effective for determining the surgical parameters. Moreover, TDR using the ProDisc-C, Mobi-C, Prestige and Bryan discs are good choices for improving functional outcomes and reducing secondary surgeries.
format	article
author	Bin Xu Jian-xiong Ma Jin-hui Tian Long Ge Xin-long Ma
author_facet	Bin Xu Jian-xiong Ma Jin-hui Tian Long Ge Xin-long Ma
author_sort	Bin Xu
title	Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease
title_short	Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease
title_full	Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease
title_fullStr	Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease
title_full_unstemmed	Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease
title_sort	indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/52bd499cfe6b478295a3600f96b5bcdd
work_keys_str_mv	AT binxu indirectmetaanalysiscomparingclinicaloutcomesoftotalcervicaldiscreplacementswithfusionsforcervicaldegenerativediscdisease AT jianxiongma indirectmetaanalysiscomparingclinicaloutcomesoftotalcervicaldiscreplacementswithfusionsforcervicaldegenerativediscdisease AT jinhuitian indirectmetaanalysiscomparingclinicaloutcomesoftotalcervicaldiscreplacementswithfusionsforcervicaldegenerativediscdisease AT longge indirectmetaanalysiscomparingclinicaloutcomesoftotalcervicaldiscreplacementswithfusionsforcervicaldegenerativediscdisease AT xinlongma indirectmetaanalysiscomparingclinicaloutcomesoftotalcervicaldiscreplacementswithfusionsforcervicaldegenerativediscdisease
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Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease

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