Artificial cervical disc arthroplasty versus anterior cervical discectomy and fusion: A systematic review

Artificial cervical disc arthroplasty is an alternative surgical procedure to anterior cervical discectomy and fusion. Some studies have proposed that artificial cervical disc arthroplasty may be superior to anterior cervical discectomy and fusion in certain clinical presentations. A Medline review of the Englishlanguage literature between January 2011 and July 2013 was performed to identify studies investigating artificial cervical disc arthroplasty. Data on relevant patient characteristics, postoperative surgical complications, and quality of life outcomes were collected. We found eight randomized controlled trials and ten nonrandomized (six prospective and four retrospective) controlled studies. Level I evidence suggests that artificial cervical disc arthroplasty has relatively low complication, reoperation, and heterotopic ossification rates and that quality of life measures such as Neck Disability Index, visual analogue scale, and Short Form 36 (SF36) significantly improved for six of the eight studies. Level II and level III evidence also suggests that artificial cervical disc arthroplasty has low complication and heterotopic ossification rates and is a safe alternative to anterior cervical discectomy and fusion when treating cervical radiculopathy and cervical myelopathy.