A meta-analysis comparing total disc arthroplasty with anterior cervical discectomy and fusion for the treatment of cervical degenerative diseases.

PURPOSE: To evaluate the efficacy and safety of total disc arthroplasty (TDA) and anterior cervical discectomy and fusion (ACDF) for treating cervical degenerative diseases.

METHODS

We conducted a comprehensive search in the electronic databases including Pubmed, Medline, EBSCO, Springer, Ovid, CNKI and Cochrane Database of Systematic Reviews. Two independent reviewers performed the data extraction from archives. All data were performed with Review Manager 5.2 software. The relative risk (RR) and its 95% confidence interval (CI) were calculated for count data. Standardized mean difference (SMD) and corresponding 95% CI for continuous outcomes were pooled.

RESULTS

After applying inclusion and exclusion criteria, nine papers were included in meta-analyses. The results of the meta-analysis indicated better neurological success, better overall success, lower incidence of secondary surgical procedures and lower incidence of secondary surgical procedures in TDA group than in ACDF group. After removing a study with considerable weight, TDA group displayed lower incidence of dysphagia and dysphonia than ACDF group.

CONCLUSION

This meta-analysis revealed that the clinical outcomes of TDA are equivalent or superior to ACDF.