ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Comparative effectiveness of posterior cervical foraminotomy versus anterior cervical discectomy with fusion for single-level cervical radiculopathy: a target trial emulation study.
Article in 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. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo estimate the comparative effectiveness of posterior cervical foraminotomy (PCF) versus anterior cervical discectomy with fusion (ACDF) for single-level cervical radiculopathy in Chinese hospitals, using the target trial emulation framework guided by the FACET randomized trial protocol.
designTarget trial emulation using retrospective electronic health record data with propensity score matching and doubly robust estimation. FACET noninferiority margins served as clinical benchmarks for interpretation.
settingTwo Tertiary A teaching hospitals in China, January 2020 to October 2024.
participants1876 eligible adults (890 PCF, 986 ACDF). Propensity score matching yielded 743 pairs (n = 1486).
main outcome measuresCo-primary outcomes: Odom procedural success and visual analogue scale arm pain at 1 year. SECONDARY OUTCOMES: neck pain, reoperation, complications, and length of stay. Approximately 43% of primary outcomes were missing; results are hypothesis-generating.
resultsAfter matching, covariate balance was adequate (15/17 standardized mean differences < 0.10). Odom success was 82.5% for PCF versus 74.9% for ACDF (risk difference, + 7.7% points; 95% CI, 2.1 to 13.2). Mean arm pain was 23.2 versus 25.6 mm (difference, - 2.4 mm; 95% CI, - 4.8 to - 0.0), a difference well below the minimal clinically important difference and therefore not clinically meaningful. Both estimates fell within the FACET noninferiority benchmarks. Complications were lower for PCF (3.4% vs. 10.5%; P < 0.001), driven by ACDF-specific dysphagia (7.8%). Subgroup analysis showed a significant interaction by pathology type (P = 0.01); this finding is exploratory and hypothesis-generating. Results were robust across seven sensitivity analyses including doubly robust estimation and tipping-point analysis.
conclusionsPCF and ACDF produced broadly comparable clinical outcomes at 1 year, with PCF showing fewer perioperative complications. The treatment effect varied by pathology type. Because follow-up was limited to 1 year, longer-term durability outcomes such as adjacent-segment disease, pseudarthrosis, and recurrent radiculopathy could not be assessed. These hypothesis-generating findings support further prospective investigation of PCF as a potential alternative to ACDF in selected Chinese patients.
Indexed as
Identifiers
42467208What OpenQuestion holds
Registered trials
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.