Comparison of postoperative pain and neck function between cervical disc replacement and anterior cervical discectomy and fusion: a meta-analysis.

Abstract

Objective To evaluate the postoperative pain and neck function of patients who under-went cervical disc replacement or anterior cervical discectomy and fusion (ACDF) by Meta-analysis. Meth-otis In Medline (1966.1-2008.11), Embase (1966.1-2008.11), AMED (1985.1-2008.11) and Cochrane Li-brary, the randomized controlled trails about the comparison between cervical disc replacement and ACDF were collected. Then extracted the data of arm pain visual analogue scale (VAS), neck pain VAS and neck disability index (NDI) in these researches and made a Meta-analysis using Review Manager 4.2. Weighted mean difference (WMD) was selected for the evaluation of the overall effect. Results Four articles were ac-cepted in our Meta-analysis and all of them were high quality researches identified by modified Jadad Scale.Altogether, 213 patients were included. The combined WMD of arm pain VAS was -2.91[95% confidence in-terval (CI) (-4.19,-1.62), P< 0.05] 6 weeks after surgery and -2.67[95%CI (-4.02,-1.33), P<0.05] 6 months after surgery. The combined WMD of NDI was -11.93[95%CI (-15.66,-8.19), P< 0.05] 6 weeks after surgery and -11.2[95%CI (-14.74,-7.69), P< 0.05] 6 months after surgery. Conclusion The arm pain VAS of treatment group (cervical disc replacement) is lower than that of control group (ACDF) both 6 weeks and 6 months after surgery. The NDI of treatment group is lower than that of control group both 6 weeks and 6 months after surgery. Key words: Intervertebral disk; Spinal fusion; Decompression; surgical; Meta-analysis