Comparison of cervical disc arthroplasty versus anterior cervical discectomy and fusion for the treatment of single-segment cervical degenerative disc disease with a minimum of 4-year follow-up: a systematic review and meta-analysis of randomized controlled trials.

Abstract

Our aim was to evaluate long-term effectiveness and safety of cervical disc arthroplasty (CDA) compared to anterior cervical discectomy and fusion (ACDF) in single-segment cervical degenerative disc disease (CDDD). Comprehensive literature searches were performed in four databases from their inception until February 6, 2025. Meta-analyses were conducted with use of Stata 17.0. Seventeen randomized controlled trials were included in our meta-analysis. CDA group exhibited greater blood loss but demonstrated a higher neurological success rate, an increased range of motion, and lower scores on neck disability index as well as visual analog scales. Additionally, reoperation rates and adjacent segment degeneration rates were significantly reduced in comparison to ACDF group. There were no significant differences between two groups in surgical duration or adverse event rates. In the long term, cervical disc arthroplasty presents favorable safety profile for treating single-segment CDDD with lower reoperation rates while demonstrating superior efficacy over ACDF along with effective reduction in adjacent segment degeneration rates.