Evidence map›Paper›PMID 40882232›Full record

SynthesisJournal of neurosurgery. Spine2025

Randomized controlled trials comparing cervical disc arthroplasty and anterior cervical discectomy and fusion outcomes in degenerative spine disease: a systematic review and meta-analysis.

Salim Yakdan, Braeden Benedict, Kathleen Botterbush, Adhya Lagisetty, Muhammad Irfan Kaleem, Rachel Alessio, Angela Hardi, Saad Javeed, Miguel A Ruiz-Cardozo, Alexander T Yahanda and 4 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in Journal of neurosurgery. Spine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. ACDF and cervical disc replacement for single-level cervical spine degenerative disease: a frailty driven propensity score-matched comparative analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Salim Yakdan1Department of Neurological Surgery, Washington University, St. Louis, Missouri.
Braeden Benedict1Department of Neurological Surgery, Washington University, St. Louis, Missouri.
Kathleen Botterbush1Department of Neurological Surgery, Washington University, St. Louis, Missouri.
Adhya Lagisetty1Department of Neurological Surgery, Washington University, St. Louis, Missouri.
Muhammad Irfan Kaleem1Department of Neurological Surgery, Washington University, St. Louis, Missouri.
Rachel Alessio1Department of Neurological Surgery, Washington University, St. Louis, Missouri.
Angela Hardi2Becker Medical Library, Washington University, St. Louis, Missouri.
Saad Javeed1Department of Neurological Surgery, Washington University, St. Louis, Missouri.
Miguel A Ruiz-Cardozo1Department of Neurological Surgery, Washington University, St. Louis, Missouri.
Alexander T Yahanda1Department of Neurological Surgery, Washington University, St. Louis, Missouri.
Jing Wang3Department of Biostatistics, Washington University, St. Louis, Missouri; and.
Mohamad Bydon4Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota.
Wilson Z Ray1Department of Neurological Surgery, Washington University, St. Louis, Missouri.
Jacob K Greenberg1Department of Neurological Surgery, Washington University, St. Louis, Missouri.

Funding

Using Mobile Health Technology and Real-Time Assessments to Address Multilevel Influences on Lumbar Spine Surgery OutcomesK23AR082986 · NIAMS · WASHINGTON UNIVERSITY · PI JACOB GREENBERG · 2024 to 2026
$515k
NIAMS NIH HHS K23 AR082986
6 · The paper itself

Abstract

objectiveAnterior cervical discectomy and fusion (ACDF) is an established treatment for cervical degenerative disc disease; however, the procedure can cause loss of cervical spine range of motion and potentially accelerate adjacent segment degeneration. Cervical disc arthroplasty (CDA) seeks to preserve native motion of the cervical spine, which can theoretically reduce the incidence of adjacent level degeneration. The literature regarding the relative efficacy of ACDF versus CDA remains inconsistent. In this study, the authors investigate the difference in outcomes between ACDF and CDA and identify factors contributing to the heterogeneity in the literature.

methodsThe Ovid, Embase, Scopus, Cochrane, and ClinicalTrials.gov databases were systematically searched from inception to September 5, 2023, for randomized controlled trials (RCTs) comparing ACDF and CDA for degenerative disc disease. Studies were extracted by two authors and verified by a third. Random-effects meta-analysis was performed. The primary outcome was the difference in clinical outcomes between the two surgical groups. The secondary outcomes were the differences in radiological outcomes, surgical characteristics, complication rates, and hospital lengths of stay. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration no. CRD42023469204) and adhered to the PRISMA guidelines.

resultsFrom 584 articles uploaded to the Covidence platform for screening, 35 studies derived from 25 RCTs were included in this systematic review and meta-analysis. A total of 4530 patients were treated with ACDF (2081) and CDA (2449). Forty-six percent of the patients (2063) were male, and the mean age of the study cohort was 45 ± 3 years. In terms of the primary outcome, CDA showed higher rates of neurological and overall success. Regarding the secondary outcomes, CDA demonstrated a significantly lower rate of adjacent level disease, higher rate of heterotopic ossification, and greater range of motion at the operated level. Additionally, CDA had lower rates of reoperation but significantly longer operative times than ACDF. The inclusion of myelopathic patients and variations in follow-up between the surgical groups contributed to the observed effect heterogeneity among studies.

conclusionsIn this study, CDA showed comparable or potentially greater success in overall and neurological outcomes, along with a lower incidence of adjacent level degeneration and reoperation rates but longer operative times.

Indexed as

ArthroplastyCervical VertebraeDiskectomyIntervertebral Disc DegenerationSpinal FusionTotal Disc ReplacementHumansRandomized Controlled Trials as TopicRange of Motion, ArticularTreatment OutcomeACDFCDAcervical spinedegenerative spine diseasesurgical outcomes

Identifiers

PMID40882232
PMCPMC13179718

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.