The study authors searched PubMed, EMBASE and Cochrane Central Register of Controlled Trials to include data from randomized controlled trials for adjacent segment disease after disc replacement and fusion. There were two independent authors selecting qualified studies.
There were 14 randomized controlled trials with 3,235 participants who had at least a two-year follow-up that were included in this meta-analysis. There were 1,696 disc replacement patients and 1,539 fusion patients.
The researchers found:
1. The patients who underwent disc replacement reported superior outcomes when compared with spinal fusion patients.
2. The disc replacement patients reported a lower rate of adjacent segment disease than the fusion patients.
3. There were significantly fewer reoperations due to adjacent segment disease among the disc replacement patients than the fusion patients.
4. The study authors concluded, "CDA may be a better surgical procedure to reduce the incidence of ASD for patients with cervical disc disease compared with ACDF."
5. The study authors mentioned additional studies should focus on the patients with long-term follow-up to evaluate ASD among the two procedures.
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