Cervical Degenerative Disease Treatment: A Systematic Review

Project Summary Title and Description

Title
Cervical Degenerative Disease Treatment: A Systematic Review
Description
Objectives. Cervical degenerative disease (CDD) is common, becomes more prevalent with age and is managed with surgical and nonoperative treatments to alleviate pain, improve function, and prevent progression or recurrence. This systematic review summarizes the evidence on treatments for CDD. Data sources. We searched Ovid MEDLINE®, EMBASE, and Cochrane CENTRAL from 1980 to February 15, 2023, reference lists, and clinical trial registries. Review methods. Predefined criteria were used to identify studies; prespecified methods were used to assess study quality and strength of evidence for key outcomes. Effects were analyzed qualitatively and quantitatively where appropriate. Results. We included 57 randomized controlled trials, 56 nonrandomized studies, and 1 systematic review. Studies enrolled patients with radiculopathy and/or myelopathy with disease at one or more levels. A variety of surgical approaches were used; there were few comparative studies of nonoperative treatments. Most studies were rated moderate risk of bias, while the majority of evidence was rated low or insufficient strength to draw conclusions on comparative benefits and harms. Cervical arthroplasty versus anterior cervical discectomy and fusion (ACDF): In single-level disease, there were no important differences between cervical arthroplasty and ACDF in pain or function. Cervical arthroplasty was associated with a lower likelihood of reoperation and slightly lower likelihood of any serious adverse event (SAE) in the short term, with no difference between cervical arthroplasty and ACDF in SAEs longer term. In patients with 2-level disease, pain, function and likelihood of reoperation at the index level were similar, but the likelihood of an adverse event was slightly lower at 24 months with cervical arthroplasty, with no difference at 120 months. Anterior versus posterior approach: There was no difference between these approaches in pain, function, quality of life, and reoperation in patients with fewer than three operated levels. Limited evidence suggests that a posterior approach is associated with a greater likelihood of experiencing any SAE in patients with procedures at three or more levels. Standalone cage versus plate and cage in ACDF: Fusion rates were similar between standalone cage versus plate and cage; there were no differences between treatments in postoperative arm pain, function, quality of life, or adjacent-level ossification. Laminoplasty versus laminectomy and fusion. There were little differences between surgical techniques in postoperative function, but the risk of experiencing a complication was lower with laminoplasty, with no difference in reoperation rates. Conclusions. There were few differences in benefits between surgical approaches and techniques for the treatment of CDD. However, there were some differences in the frequency of adverse events for some comparisons.
Attribution
Pacific Northwest EPC
Authors of Report
Shelley S. Selph, MD, MPH; Andrea C. Skelly, PhD, MPH; Rebecca M. Jungbauer, DrPH, MA; Erika Brodt, BS; Ian Blazina, MPH; Travis C. Philipp, MD; Kimberly M. Mauer, MD; Joseph Dettori, PhD, MPH, MPT; Chandler Atchison, MPH; Dakota Riopelle, MPH; Shay Stabler-Morris, MS; Rochelle Fu, PhD; Yun Yu, MS; Roger Chou, MD
Methodology description
Systematic Review
PROSPERO
CRD42023386838
DOI
N/A
Notes
Project data was entered prospectively.
Funding Source
AHRQ

Key Questions

1. Key Question 1: In patients with radiographic spinal cord compression and no cervical spondylotic myelopathy, what are the comparative effectiveness and harms of surgery compared to non-operative treatment or no treatment?
2. Key Question 2: In patients with radiographic spinal cord compression and mild to severe myelopathy, what is the effectiveness and harms of surgery versus non-operative treatment or no treatment? How do the effectiveness and harms vary by level of severity of myelopathy at the time of surgery?
3. Key Question 3: In patients with cervical degenerative disease, what are the comparative effectiveness and harms of surgical compared to non-operative treatment?
4. Key Question 4: In patients with cervical degenerative disease, what are the comparative effectiveness and harms of therapies added on to surgery (pre- or post-operative) compared with the same surgery alone?
5. Key Question 5: In patients with cervical radiculopathy due to cervical degenerative disease, what are the comparative effectiveness and harms of posterior versus anterior surgery?
6. Key Question 6: In patients with cervical degenerative disease, what are the comparative effectiveness and harms of posterior versus anterior surgery in patients with greater than or equal to three level disease?
7. Key Question 7: In patients with cervical spondylotic myelopathy due to cervical degenerative disease, what are the comparative effectiveness and harms of cervical laminectomy and fusion compared to cervical laminoplasty in patients?
8. Key Question 8: In patients with cervical spondylotic radiculopathy or myelopathy at one or two levels, what are the comparative effectiveness and harms of cervical arthroplasty compared to anterior cervical discectomy and fusion?
9. Key Question 9: In patients undergoing anterior cervical discectomy and fusion, what are the comparative effectiveness and harms of surgery based on interbody graft material or device type?
10. Key Question 10: In patients with pseudarthrosis after prior anterior cervical fusion surgery, what are the comparative effectiveness and harms of posterior approaches compared to revision anterior arthrodesis?
11. Key Question 11: In patients with cervical spondylotic myelopathy, what is the prognostic utility of preoperative magnetic resonance imaging (MRI) findings for neurologic recovery after surgery?
12. Key Question 12: What is the sensitivity and specificity of imaging assessment for identifying symptomatic pseudarthrosis after prior cervical fusion surgery?
13. Key Question 13: In patients with cervical spondylotic myelopathy, what are the comparative effectiveness and harms of intraoperative neuromonitoring (e.g., with somatosensory or motor evoked potential measurements) versus no neuromonitoring on clinical outcomes in patients undergoing surgery?

Associated Extraction Forms

Type
Standard

Associated Studies (each link opens a new tab)

Title Authors Year
Superiority of the Bryan(®) disc prosthesis for cervical myelopathy: a randomized study with 3-year followup. Cheng, L., Nie, L., Li, M., Huo, Y., Pan, X. 2011
Perioperative complications of surgery for degenerative cervical myelopathy: a comparison between 3 procedures. Mesregah, M. K., Formanek, B., Liu, J. C., Buser, Z., Wang, J. C. 2021
What is the impact of surgical approach in the treatment of degenerative cervical myelopathy in patients with OPLL? A propensity-score matched, multi-center analysis on inpatient and post-discharge 90-day outcomes. Lee, N. J., Boddapati, V., Mathew, J., Fields, M., Vulapalli, M., Kim, J. S., Lombardi, J. M., Sardar, Z. M., Lehman, R. A., Riew, K. D. 2021
Anterior cervical corpectomy for treatment of spondylotic myelopathy. Results of a prospective double-armed study with a three-year follow-up. Colamaria, A., Ciappetta, P., Fochi, N. P., Carbone, F., Leone, A. 2022
Prospective, multicenter study of 2-level cervical arthroplasty with a PEEK-on-ceramic artificial disc. Coric, D., Guyer, R. D., Bae, H., Nunley, P. D., Strenge, K. B., Peloza, J. H., Boltes, M. O., Ohnmeiss, D. D. 2022
Two-level cervical disc arthroplasty versus anterior cervical discectomy and fusion: 10-year outcomes of a prospective, randomized investigational device exemption clinical trial. Gornet, M. F., Lanman, T. H., Burkus, J. K., Dryer, R. F., McConnell, J. R., Hodges, S. D., Schranck F. W. 2019
A comparison of various surgical treatments for degenerative cervical myelopathy: a propensity score matched analysis Lee, N. J., Kim, J. S., Park, P., Riew, K. D. 2022
Long-term clinicoradiological outcomes of cervical fusion with polyether ether ketone versus cervical disc arthroplasty in a double-blinded randomized control trial. Gupta, V. K., Basantani, N., Carvalho, A. S., Gupta E. 2021
Four-level anterior versus posterior cervical fusions: perioperative outcomes and five-year reoperation rates: outcomes after four-level anterior versus posterior cervical procedures. Joo, P. Y., Jayaram, R. H., McLaughlin, W. M., Ameri, B., Kammien, A. J., Arnold, P. M., Grauer, J. N. 2022
PEEK versus titanium-coated PEEK cervical cages: fusion rate. Godlewski, B., Bebenek, A., Dominiak, M., Karpinski, G., Cieslik, P., Pawelczyk, T. 2022
Stand-alone cage versus anterior plating for 1-level and 2-level anterior cervical discectomy and fusion: a randomized controlled trial. Zavras, A. G., Nolte, M. T., Sayari, A. J., Singh, K., Colman, M. W. 2022
The impact of modic changes on preoperative symptoms and clinical outcomes in anterior cervical discectomy and fusion patients. Baker, J. D., Harada, G. K, Tao, Y., Louie, P. K., Basques, B. A., Galbusera, F., Niemeyer, F., Wilke, H. J., An, H. S., Samartzis, D. 2020
Anterior cervical discectomy and fusion versus cervical disc arthroplasty: a comparison of national trends and outcomes. Ostrov, P. B., Reddy, A. K., Ryoo, J. S., Behbahani, M., Mehta, A. I. 2022
Prospective, multicenter clinical trial comparing M6-C compressible six degrees of freedom cervical disc with anterior cervical discectomy and fusion for the treatment of single-level degenerative cervical radiculopathy: 2-year results of an FDA investigational device exemption study. Phillips, F. M., Coric, D., Sasso, R., Lanman, T., Lavelle, W., Blumenthal, S., Lauryssen, C., Guyer, R., Albert, T., Zigler, J., Cammisa, F., Milam, R. A. 2020
Comparison of adverse events between cervical disc arthroplasty and anterior cervical discectomy and fusion: a 10-year follow-up. Loidolt, T., Kurra, S., Riew, K. D., Levi, A. D., Florman, J., Lavelle, W. F. 2021
Cervical spine endplate abnormalities and association with pain, disability, and adjacent segment degeneration after anterior cervical discectomy and fusion. Harada, G. K., Alter, K., Nguyen, A. Q., Tao, Y., Louie, P. K., Basques, B. A., Galbusera, F., Niemeyer, F., Wilke, H. J., An H. S., Samartzis D. 2020
Could self-locking stand-alone cage reduce adjacent-level ossification development after aneterior cervical discectomy and fusion? Zhou, J., Li, J., Lin, H., Li, X., Dong, J., Zhou, X. 2020
Two-level ACDF with a zero-profile stand-alone spacer compared to conventional plating: a prospective randomized single-center study. Scholz, M., Onal, B., Schleicher, P., Pingel, A., Hoffmann, C., Kandziora, F. 2020
Comparison of the inpatient complications and health care costs of anterior versus posterior cervical decompression and fusion in patients with multilevel degenerative cervical myelopathy: a retrospective propensity score-matched analysis. Badhiwala, J. H., Ellenbogen, Y., Khan, O., Nouri, A., Jiang, F., Wilson, J. R. F., Jaja, B., Witiw, C. D., Nassiri, F., Fehlings, M. G., Wilson, J. R. 2020
Comparison of outcomes following anterior vs posterior fusion surgery for patients with degenerative cervical myelopathy: an analysis from quality outcomes database. Asher, A. L., Devin, C. J., Kerezoudis, P., Chotai, S., Nian, H., Harrell, F. E., Sivaganesan, A., McGirt, M. J., Archer, K. R., Foley, K. T., Mummaneni, P. V., Bisson, E. F., Knightly, J. J., Shaffrey, C. I., Bydon, M. 2019
Symptomatic adjacent level disease requiring surgery: analysis of 10-year results from a prospective, randomized, clinical trial comparing cervical disc arthroplasty to anterior cervical fusion. Ghobrial, G. M., Lavelle, W. F., Florman, J. E., Riew, K. D., Levi, A. D. 2018
Superiority of 2-level total disk replacement using a cervical disk prosthesis versus anterior cervical diskectomy and fusion. Yang, W., Si, M., Hou, Y., Nie, L. 2018
Reoperation and complications after anterior cervical discectomy and fusion and cervical disc arthroplasty: a study of 52,395 cases. Kelly, M. P., Eliasberg, C. D., Riley, M. S., Ajiboye, R. M., SooHoo, N. F. 2018
What's the best surgical treatment for patients with cervical radiculopathy due to single-level degenerative disease? A randomized controlled trial. Donk, R. D., Verbeek, A. L. M., Verhagen, W. I. M., Groenewoud, H., Hosman, A. J. F., Bartels, R. H. M. A. 2017
The relationship between MRI signal intensity changes, clinical presentation, and surgical outcome in degenerative cervical myelopathy: analysis of a global cohort. Nouri, A., Martin, A. R., Kato, S., Reihani-Kermani, H., Riehm, L. E., Fehlings, M. G. 2017
Long-term clinical and radiographic outcomes of the Prestige LP artificial cervical disc replacement at 2 levels: results from a prospective randomized controlled clinical trial. Lanman, T. H., Burkus, J. K., Dryer, R. G., Gornet, M. F., McConnell, J., Hodges, S. D. 2017
Cervical disc arthroplasty with the Prestige LP disc versus anterior cervical discectomy and fusion, at 2 levels: results of a prospective, multicenter randomized controlled clinical trial at 24 months. Gornet, M. F., Lanman, T. H., Burkus, J. K., Hodges, S. D., McConnell, J. R., Dryer, R. F., Copay, A. G., Nian, H., Harrell, F. E, Jr. 2017
A clinical comparison of anterior cervical plates versus stand-alone intervertebral fusion devices for single-level anterior cervical discectomy and fusion procedures. Panchal, R. R., Kim, K. D., Eastlack, R., Lopez, J., Clavenna, A., Brooks, D. M., Joshua, G. 2017
A prospective randomized trial comparing anterior cervical discectomy and fusion versus plate-only open-door laminoplasty for the treatment of spinal stenosis in degenerative diseases. Jiang, Y. Q., Li, X. L., Zhou, X. G., Bian, C., Wang, H. M., Huang, J. M., Dong, J. 2017
Laminectomy and fusion versus laminoplasty for the treatment of degenerative cervical myelopathy: results from the AOSpine North America and International prospective multicenter studies. Fehlings, M. G., Santaguida, C., Tetreault, L., Arnold, P., Barbagallo, G., Defino, H., Kale, S., Zhou, Q., Yoon, T. S., Kopjar, B. 2017
Effectiveness and safety of Mobi-C for treatment of single-level cervical disc spondylosis: a randomised control trial with a minimum of five years of follow-up. Hou, Y., Nie, L., Pan, X., Si, M., Han, Y., Li, J., Zhang, H. 2016
Heterotopic ossification following single-level anterior cervical discectomy and fusion: results from the prospective, multicenter, historically controlled trial comparing allograft to an optimized dose of rhBMP-2. Arnold, P. M., Anderson, K. K., Selim, A., Dryer, R. F., Kenneth, Burkus J. 2016
Five-year clinical results of cervical total disc replacement compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled, multicenter investigational device exemption clinical trial. Radcliff, K., Coric, D., Albert, T. 2016
Comparative analysis of clinical outcomes between zero-profile implant and cages with plate fixation in treating multilevel cervical spondilotic myelopathy: A three-year follow-up. Chen, Y., Chen, H., Wu, X., Wang, X., Lin, W., Yuan, W. 2016
Subsequent surgery rates after cervical total disc replacement using a Mobi-C Cervical Disc Prosthesis versus anterior cervical discectomy and fusion: a prospective randomized clinical trial with 5-year follow-up. Jackson, R. J., Davis, R. J., Hoffman, G. A., Bae, H. W., Hisey, M. S, Kim, K. D., Gaede, S. E., Nunley, P. D. 2016
ProDisc-C total disc replacement versus anterior cervical discectomy and fusion for single-level symptomatic cervical disc disease: seven-year follow-up of the prospective randomized U.S. Food and Drug Administration Investigational Device Exemption Study. Janssen, M. E., Zigler, J. E., Spivak, J. M., Delamarter, R. B., Darden, B. V., Kopjar, B. 2015
Long-term outcomes of the US FDA IDE prospective, randomized controlled clinical trial comparing PCM cervical disc arthroplasty with anterior cervical discectomy and fusion. Phillips, F. M., Geisler, F. H., Gilder, K. M., Reah, C., Howell, K. M., McAfee, P. C. 2015
Anterior versus posterior approach for multilevel degenerative cervical disease: a retrospective propensity score-matched study of the MarketScan database. Cole, T., Veeravagu, A., Zhang, M., Azad, T. D., Desai, A., Ratliff, J. K. 2015
Two-level total disc replacement with Mobi-C cervical artificial disc versus anterior discectomy and fusion: a prospective, randomized, controlled multicenter clinical trial with 4-year follow-up results. Davis, R. J., Nunley, P. D., Kim, K. D., Hisey, M. S., Jackson, R. J., Bae, H. W., Hoffman, G. A., Gaede, S. E., Danielson, G. O., Gordon, C., Stone, M. B. 2015
Prospective, randomized comparison of cervical total disk replacement versus anterior cervical fusion: results at 48 months follow-up. Hisey, M.S., Bae, H. W., Davis, R. J., Gaede, S., Hoffman, G., Kim, K. D., Nunley, P. D., Peterson, D., Rashbaum, R. F., Stokes, J., Ohnmeiss, D. D. 2015
The efficiency of zero-profile implant in anterior cervical discectomy fusion: a prospective controlled long-term follow-up study. Li, Y., Hao, D., He, B., Wang, X., Yan, L. 2015
Arthroplasty versus fusion for single-level cervical disc disease. Karabag, H., Cakmak, E., Celik, B., Iplikcioglu, A. C., Soran, A. F. 2014
Clinical and radiographic analysis of an artificial cervical disc: 7-year follow-up from the Prestige prospective randomized controlled clinical trial: clinical article. Burkus, J. K., Traynelis, V. C., Haid, R. W., Mummaneni, P. V. 2014
Comparison between cervical total disc replacement and anterior cervical discectomy and fusion of 1 to 2 levels from 2002 to 2009. Nandyala, S. V., Marquez-Lara, A., Fineberg, S. 2014
Cervical total disc replacement with the Mobi-C cervical artificial disc compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled multicenter clinical trial: clinical article. Davis, R. J., Kim, K. D., Hisey, M. S., Hoffman, G. A., Bae, H. W., Gaede, S. E., Rashbaum, R. F., Nunley, P. D., Peterson, D. L., Stokes, J. K. 2013
A prospective, randomized, controlled clinical investigation comparing PCM cervical disc arthroplasty with anterior cervical discectomy and fusion. 2-year results from the US FDA IDE clinical trial. Phillips, F. M., Lee, J. Y. B., Geisler, F. H., Cappuccino, A., Chaput, C. D., DeVine, J. G., Reah, C., Gilder, K. M., Howell, K. M., McAfee, P. C. 2013
Five-year reoperation rates, cervical total disc replacement versus fusion, results of a prospective randomized clinical trial. Delamarter, R. B., Zigler, J. 2013
ProDisc-C and anterior cervical discectomy and fusion as surgical treatment for single-level cervical symptomatic degenerative disc disease: five-year results of a Food and Drug Administration study. Zigler, J. E., Delamarter, R., Murrey, D., Spivak, J., Janssen, M. 2013
Is there a need for cervical collar usage post anterior cervical decompression and fusion using interbody cages? A randomized controlled pilot trial. Abbott, A., Halvorsen, M., Dedering, A. 2013
Prospective, randomized comparison of one-level Mobi-C cervical total disc replacement vs. anterior cervical discectomy and fusion: results at 5-year follow-up. Hisey, M. S., Zigler, J. E., Jackson, R., Nunley, P. D., Bae, H. W., Kim, K.D., Ohnmeiss, D. D. 2016
Multi-center, prospective, randomized, controlled investigational device exemption clinical trial comparing Mobi-C Cervical Artificial Disc to anterior discectomy and fusion in the treatment of symptomatic degenerative disc disease in the cervical spine. Hisey, M. S., Bae, H. W., Davis, R., Gaede, S., Hoffman, G., Kim, K., Nunley, P. D., Peterson, D., Rashbaum, R., Stokes J. 2014
Long term preservation of motion with artificial cervical disc implants: a comparison between cervical disc replacement and rigid fusion with cage. Cincu, R., Lorente Francisco de, A., Gomez, J., Eiras, J., Agrawal, A. 2014
Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial. Sasso, R. C., Anderson, P. A., Riew, K. D., Heller, J. G. 2011
Assessment of adjacent-segment mobility after cervical disc replacement versus fusion: RCT with 1 year's results. Nabhan, A., Ishak, B., Steudel, W. I., Ramadhan, S., Steimer, O. 2011
Long-term clinical and radiographic outcomes of cervical disc replacement with the Prestige disc: results from a prospective randomized controlled clinical trial. Burkus, J. K., Haid, R. W., Traynelis, V. C., Mummaneni, P. V. 2010
A comparison of outcomes of cervical disc arthroplasty and fusion in everyday clinical practice: surgical and methodological aspects. Grob, D., Porchet, F., Kleinstück, F. S., Lattig, F., Jeszenszky, D., Luca, A., Mutter, U., Mannion, A. F. 2010
Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis. Anderson, P. A., Sasso, R. C., Riew, K. D. 2008
Segmental kinematics and adjacent level degeneration following disc replacement versus fusion: RCT with three years of follow-up. Nabhan, A., Steudel, W. I., Nabhan, A. H., Pape, D., Ishak, B. 2007
The ProDisc-C prosthesis: clinical and radiological experience 1 year after surgery. Nabhan, A., Ahlhelm, F., Shariat, K., Pitzen, T., Steimer, O., Steudel, W. I., Pape, D. 2007
Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. Mummaneni, P. V., Burkus, J. K., Haid, R. W., Traynelis, V. C., Zdeblick, T. A. 2007
A prospective, randomized, controlled cervical fusion study using recombinant human bone morphogenetic protein-2 with the CORNERSTONE-SR allograft ring and the ATLANTIS anterior cervical plate. Baskin, D. S., Ryan, P., Sonntag, V. Westmark, R., Widmayer, M. A. 2003
Comparison of clinical outcomes in anterior cervical discectomy versus foraminotomy for brachialgia. Foster, M. T., Carleton-Bland, N. P., Lee, M. K., Jackson, R., Clark, S. R., Wilby, M. J. 2019
Comparison of anterior cervical discectomy and fusion to posterior cervical foraminotomy for cervical radiculopathy: utilization, costs, and adverse events 2003 to 2014. Witiw, C. D., Smieliauskas, F., O'Toole, J. E., Fehlings, M. G., Fessler, R. G. 2019
Cost-utility analysis of anterior cervical discectomy and fusion with plating (ACDFP) versus posterior cervical foraminotomy (PCF) for patients with single-level cervical radiculopathy at 1-year follow-up. Alvin, M. D., Lubelski, D., Abdullah, K. G., Whitmore, R. G., Benzel, E.C., Mroz, T. E. 2016
Reoperation rates after anterior cervical discectomy and fusion versus posterior cervical foraminotomy: a propensity-matched analysis. Lubelski, D. Healy, A. T., Silverstein, M. P., Abdullah, K. G., Thompson, N. R., Riew, K. D., Steinmetz, M. P., Benzel, E. D., Mroz, T. E. 2015
Cervical laminoplasty versus posterior laminectomy and fusion: trends in utilization and evaluation of complication and revision surgery rates. McDonald, C. L., Hershman, S. H., Hogan, W., Alsoof, D., DiSilvestro, K. J., Zhang, A. S., Kuris, E. O., Daniels, A. H. 2022
Is laminectomy and fusion the better choice than laminoplasty for multilevel cervical myelopathy with signal changes on magnetic resonance imaging? A comparison of two posterior surgeries. He, X., Zhang, J. N., Liu, T. J., Hao, D. J. 2020
Collar fixation is not mandatory after cervical laminoplasty: a randomized controlled trial. Hida, T., Sakai, Y., Ito, K., Ito, S., Imagama, S., Ishiguro, N., Harada A. 2017
Laminoplasty versus laminectomy with fusion for the treatment of spondylotic cervical myelopathy: short-term follow-up. Blizzard, D. J., Caputo, A. M., Sheets, C. Z., Klement, M. R., Michael, K. W., Isaacs, R. E., Brown, C. R. 2017
A prospective, randomized trial comparing expansile cervical laminoplasty and cervical laminectomy and fusion for multilevel cervical myelopathy. Manzano, G. R., Casella, G., Wang, M. Y., Vanni, S., Levi, A. D. 2012
Laminoplasty versus laminectomy and fusion for multilevel cervical spondylotic myelopathy. Woods, B. I., Hohl, J., Lee, J., Donaldson, W., Kang, J. 2011
Treatment of Cervical Myelopathy: Long-term Outcomes of Arthroplasty for Myelopathy Versus Radiculopathy, And Arthroplasty Versus Arthrodesis for Myelopathy. Gornet, MF, McConnell, JR, Riew, KD, Lanman, TH, Burkus, JK, Hodges, SD, Dryer, RF, Copay, AG, Schranck FW. 2018
A randomized control trial comparing local autografts and allografts in single level anterior cervical discectomy and fusion using a stand-alone cage. Kanna, R. M., Perambuduri, A. S., Shetty, A. P., Rajasekaran, S. 2021
Adjacent segment pathology after treatment with cervical disc arthroplasty or anterior cervical discectomy and fusion, part 2: clinical results at 7-year follow-up. Nunley, P. D., Kerr, E. J., Cavanaugh, D. A., Utter, P. A., Campbell, P. G., Wadhwa, R., Frank, K. A., Marshall, K. E., Stone, M. B. 2020
Long-term clinical experience with selectively constrained SECURE-C cervical artificial disc for 1-level cervical disc disease: results from seven-year follow-up of a prospective, randomized, controlled investigational device exemption clinical trial. Vaccaro, A., Beutler, W., Peppelman, W., Marzluff, J., Mugglin, A., Ramakrishnan, P. S., Myer, J., Baker, K. J. 2018
Anterior cervical discectomy and fusion versus laminoplasty for multilevel cervical spondylotic myelopathy: a National Administrative Database Analysis. Wadhwa, H., Sharma, J., Varshneya, K., Fatemi, P., Nathan, J., Medress, Z. A., Stienen, M. N., Ratliff, J. K., Veeravagu, A. 2021
Investigating the utility of intraoperative neurophysiological monitoring for anterior cervical discectomy and fusion: analysis of over 140,000 cases from the National (Nationwide) Inpatient Sample data set. Badhiwala, J. H., Nassiri, F., Witiw, C. D., Mansouri, A., Almenawer, S. A., da Costa, L., Fehlings, M. G., Wilson, J. R. 2019
Ten-year outcomes of cervical disc replacement with the BRYAN cervical disc: results from a prospective, randomized, controlled clinical trial. Lavelle, W. F., Riew, K. D., Levi, A. D., Florman, J. E. 2019
A randomized trial comparing clinical outcomes between zero-profile and traditional multilevel anterior cervical discectomy and fusion surgery for cervical myelopathy. He, S., Feng, H., Lan, Z., Lai, J., Sun, Z., Wang, Y., Wang, J., Ren, Z., Huang, F., Xu, F. 2018
i-Factor™ bone graft vs autograft in anterior cervical discectomy and fusion: 2-year follow-up of the randomized single-blinded Food and Drug Administration Investigational Device Exemption Study. Arnold, P. M., Sasso, R. C., Janssen, M. E., Fehlings, M. G., Heary, R. F., Vaccaro, A. R., Kopjar, B. 2018
Routine use of intraoperative neuromonitoring during ACDFs for the treatment of spondylotic myelopathy and radiculopathy is questionable: a review of 15,395 cases. Ajiboye, R. M. D'Oro, A., Ashana, A. O., Buerba, R. A., Lord, E. L., Buser, Z., Wang, J. C., Pourtaheri, S. 2017
Efficacy of i-Factor bone graft versus autograft in anterior cervical discectomy and fusion: results of the prospective, randomized, single-blinded Food and Drug Administration Investigational Device Exemption Study. Arnold, P. M., Sasso, R. C., Janssen, M. E., Fehlings, M. G., Smucker, J. D., Vaccaro, A. R., Heary, R. F., Patel, A. I., Goulet, B., Kalfas, I. H., Kopjar B., Branko 2016
A prospective randomized comparison of PEEK cage containing calcium sulphate or demineralized bone matrix with autograft in anterior cervical interbody fusion. Xie, Y., Li, H., Yuan, J., Fu, L., Yang, J., Zhang, P. 2015
Stand-alone anchored cage versus cage with plating for single-level anterior cervical discectomy and fusion: a prospective, randomized, controlled study with a 2-year follow-up. Nemoto, O., Kitada, A., Naitou, S., Tachibana, A., Ito, Y., Fujikawa, A. 2015
Clinical outcomes with selectively constrained SECURE-C cervical disc arthroplasty: two-year results from a prospective, randomized, controlled, multicenter investigational device exemption study. Vaccaro, A., Beutler, W., Peppelman, W., Marzluff, J. M., Highsmith, J., Mugglin, A., DeMuth, G., Gudipall, M., Baker, K. J. 2013
Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up. Chen, Y., Wang, X., Lu, X., Yang, L., Yang, H., Yuan, W., Chen, D. 2013
A prospective randomized clinical trial comparing bone union rate following anterior cervical discectomy and fusion using a polyetheretherketone cage: hydroxyapatite/B-Tricalcium phosphate mixture versus hydroxyapatite/demineralized bone matrix mixture. Yi, J., Lee, G.W., Nam, W. D., Han, K. Y., Kim, M. H., Kang, J. W., Won, J., Kim, S. W., Noh, W., Yeom, J. S. 2015
Results at 24 months from the prospective, randomized, multicenter Investigational Device Exemption trial of ProDisc-C versus anterior cervical discectomy and fusion with 4-year follow-up and continued access patients. Delamarter, R. B., Murrey, D., Janssen, M. E., Goldstein, J. A., Zigler, J., Tay, B. K., Darden, B. 2010
Outcomes of interbody fusion cages used in 1 and 2-levels anterior cervical discectomy and fusion: titanium cages versus polyetheretherketone (PEEK) cages. Niu, C. C., Liao, J. C., Chen, W. J., Chen, L. H. 2010
Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial. Heller, J. G., Sasso, R. C., Papadopoulos, S. M., Anderson, P. A., Fessler, R. G., Hacker, R. J., Coric, D., Cauthen, J. C., Riew D. K. 2009
Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Murrey, D., Janssen, M., Delamarter, R., Goldstein, J., Zigler, J., Tay, B., Darden, B. 2009
Randomized, prospective, and controlled clinical trial of pulsed electromagnetic field stimulation for cervical fusion. Foley, K. T., Mroz, T. E., Arnold, P. M., Chandler, H. C., Dixon, R. A., Girasole, G. J., Renkens, K. L., Riew, K. D., Sasso R. C., Smith R. C., Tung, H., Wecht D. A., Whiting D. M. 2008
What is the role of dynamic cervical spine radiographs in predicting pseudarthrosis revision following anterior cervical discectomy and fusion? Lambrechts, M. J., D'Antonio, N. D., Karamian, B. A., Toci, G. R., Sherman, M., Canseco, J. A., Kepler, C. K., Vaccaro, A. R., Hilibrand, A. S., Schroeder, G. D 2022
Anterior vs posterior approach in multilevel cervical spondylotic myelopathy: a nationwide propensity-matched analysis of complications, outcomes, and narcotic use. Nunna, R. S., Khalid, S., Chiu, R. G., Parola, R., Fessler, R. G., Adogwa, O., Mehta A. I. 2022
Dynamic radiographic criteria for detecting pseudarthrosis following anterior cervical arthrodesis. Song, K. S., Piyaskulkaew, C., Chuntarapas, T., Buchowski, J. M., Kim, H. J., Park, M. S., Kang, H., Riew D.K. 2014
Increased signal intensity of spinal cord on T2W magnetic resonance imaging for cervical spondylotic myelopathy patients: Risk factors and prognosis (a STROBE-compliant article). Yin, L. Q., Zhang, J., Wu, Y. G., Li, J. H., Yang, Q. 2020
Interplay of dynamic extension reserve and T1 slope in determining the loss of cervical lordosis following laminoplasty: a novel classification system. Sharma, R., Borkar, S., Katiyar, V., Goda, R., Phalak, M., Joseph, L., Suri , A., Chandra, P. S., Kales, S. S. 2020
Clinical and magnetic resonance imaging predictors of the surgical outcomes of patients with cervical spondylotic myelopathy. Li, X. Y., Lu, S. B., Sun, X. Y., Kong, C., Guo, M. S., Sun, S. Y., Ding, J. Z., Yang, Y. M. 2018
Signal intensity ratio on magnetic resonance imaging as a prognostic factor in patients with cervical compressive myelopathy. Kim, T. H., Ha, Y., Shin, J. J., Cho, Y. E., Lee, J. H., Cho, W. H. 2016
Predictors of surgical outcome in cervical spondylotic myelopathy: focusing on the quantitative signal intensity. Zhang, J. T., Meng, F. T., Wang, S., Wang, L. F., Shen, Y. 2015
The evolution of T2-weighted intramedullary signal changes following ventral decompressive surgery for cervical spondylotic myelopathy: Clinical article. Sarkar, S., Turel, M. K., Jacob K. S., Chacko, A. G. 2014
Prognostic value of changes in spinal cord signal intensity on magnetic resonance imaging in patients with cervical compressive myelopathy. Uchida, K., Nakajima, H. Takeura, N., Yayama, T., Guerrero A. R., Yoshida, A., Sakamoto, T., Honjoh, K., Baba, H. 2014
Does the type of T2-weighted hyperintensity influence surgical outcome in patients with cervical spondylotic myelopathy? A review. Vedantam, A., Rajshekhar, V. 2013
Prediction of surgical outcome in compressive cervical myelopathy: a novel clinicoradiological prognostic score. Aggarwal, R. A., Srivastava, S. K., Bhosale, S. K., Nemade, P. S. 2016
Significance of increased signal intensity on MRI in prognosis after surgical intervention for cervical spondylotic myelopathy. Zhang, P., Shen, Y., Zhang, Y. Z., Ding, W. Y., Wang, L. F. 2011
Effect of intramedullary signal changes on the surgical outcome of patients with cervical spondylotic myelopathy. Suri, A., Chabbra, R. P., Singh, Mehta, V. S., Gaikwad, S., Pandey, R. M. 2003
Correlation between operative outcomes of cervical compression myelopathy and mri of the spinal cord. Morio, Y., Teshima, R., Nagashima, H., Nawata, K., Yamasaki, D., Nanjo, Y. 2001
Outcomes of cervical degenerative disc disease treated by anterior cervical discectomy and fusion with self-locking fusion cage. Zhang, B., Jiang, Y. Z., Song, Q. P., An, Y. 2022
Cage containing a biphasic calcium phosphate ceramic (Triosite) for the treatment of cervical spondylosis. Cho, D. Y., Lee, W. Y., Sheu, P. C., Chen, C. C. 2005
Magnetic resonance imaging study on spinal cord plasticity in patients with cervical compression myelopathy. Fukushima, T., Ikata, T., Taoka, Y., Takata, S. 1991
Predictive factors for mild forms of spondylotic cervical myelopathy treated conservatively or surgically. Kadanka, Z., Mares, M., Bednarík, J., Smrcka, V., Krbec, M., Chaloupka, R., Dusek, L. 2005
Pain, coping, emotional state and physical function in patients with chronic radicular neck pain. A comparison between patients treated with surgery, physiotherapy or neck collar--a blinded, prospective randomized study. Persson, L. C., Lilja, A. 2001
Cervical radiculopathy: pain, muscle weakness and sensory loss in patients with cervical radiculopathy treated with surgery, physiotherapy or cervical collar. A prospective, controlled study. Persson, L. C., Moritz, U., Brandt, L., Carlsson, C. A. 1997
Increased swelling complications associated with off-label usage of rhBMP-2 in the anterior cervical spine. Smucker, J. D., Rhee, J. M., Singh, K., Yoon, S. T., Heller, J. G. 2006
Cervical discectomy. A prospective analysis of three operative techniques. Wirth, F. P., Dowd, G. C., Sanders, H. F., Wirth, C. 2000
Evaluation of DTI parameter ratios and diffusion tensor tractography grading in the diagnosis and prognosis prediction of cervical spondylotic myelopathy. Wang, K., Chen, Z., Zhang, F., Song, Q., Hou, C., Tang, Y., Wang, J., Chen, S., Bian, Y., Hao, Q., Shen, H. 2017
Thirty-day readmission and reoperation rates after single-level anterior cervical discectomy and fusion versus those after cervical disc replacement. Bhashyam, N., De la Garza Ramos, R., Nakhla, J., Nasser, R., Jada, A., Purvis, T. E, Sciubba, D. M., Kinon, M. D., Yassari, R. 2017
Fusion versus Bryan Cervical Disc in two-level cervical disc disease: a prospective, randomised study. Cheng, L., Nie, L., Zhang, L., Hou, Y. 2009
Randomized, controlled, multicenter, clinical trial comparing BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion in China. Zhang, X., Zhang, X., Chen, C., Zhang, Y., Wang, Z., Wang, B., Yan, W., Li, M., Yuan, W., Wang, Y. 2012
A prospective, randomised, controlled multicentre study comparing cervical disc replacement with anterior cervical decompression and fusion. Zhang, H. X., Shao, Y. D., Chen, Y., Hou, Y., Cheng, L., Si, M., Nie, L. 2014
Cervical disc prosthesis replacement and interbody fusion: a comparative study. Peng-Fei, S., Yu-Hua, J. 2008
Anterior versus posterior surgical approaches to treat cervical spondylotic myelopathy: outcomes of the prospective multicenter AOSpine North America CSM study in 264 patients. Fehlings, M. G., Barry, S., Kopjar, B., Yoon, S. T., Arnold, P., Massicotte, E. M., Vaccaro, A., Brodke, D. S., Shaffrey, S., Smith, J. S., Woodard, E., Banco, R. J., Chapman, J., Janssen, M., Bono, C., Sasso, R., Dekutoski, M., Gokaslan, Z. L. 2013
Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Ruetten, S., Komp, M., Merk, H., Godolias, G. 2008
Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years. Kadaňka, Z., Bednařík, J., Novotný, O., Urbánek, I., Dušek, L. 2011
Approaches to spondylotic cervical myelopathy: conservative versus surgical results in a 3-year follow-up study. Kadanka, Z., Mares, M., Bednaník, J., Smrcka, V., Krbec, M., Stejskal, L., Chaloupka, R., Surelová, D., Novotný, O., Urbánek, I., Dusek, L. 2002
Comparison of clinical outcomes between cervical disc arthroplasty and anterior cervical discectomy and fusion for the treatment of single-level cervical spondylosis: a 10-year follow-up study. Qi, M., Xu, C., Liu, Y., Cao, P., Wang, X., Chen, H., Yuan, W. 2023
Multi-level posterior cervical foraminotomy associated with increased post-operative infection rates and overall re-operation relative to anterior cervical discectomy with fusion or cervical disc arthroplasty. Ng, M. K., Kobryn, A., Baidya, J., Nian, P., Emara, A. K., Ahn, N. U., Houten, J. K., Saleh, A., Razi, A. E. 2022
Noninferiority of posterior cervical foraminotomy vs anterior cervical discectomy with fusion for procedural success and reduction in arm pain among patients with cervical radiculopathy at 1 year: the FACET randomized clinical trial. Broekema, A. E. H., Simões de Souza, N. F., Soer, R., Koopmans, J., van Santbrink, H., Arts, M. P., Burhani, B., Bartels, R. H. M. A., van der Gaag, N. A., Verhagen, M. P. H., Tamási, K., van Dijk, J. M. C., Reneman, M. F., Groen, R. J. M., Kuijlen, J. M. A., FACET investigators. 2023
Reoperation and Perioperative Complications After Surgical Treatment of Cervical Radiculopathy: A Comparison Between Three Procedures. Nayak, R., Razzouk, J., Ramos, O., Ruckle, D., Chiu, A., Parel, P., Stoll, W. T., Patel, S., Thakkar, S., Danisa, O. A. 2023
Six-year follow-up of a randomized controlled trial of i-FACTOR peptide-enhanced bone graft versus local autograft in single-level anterior cervical discectomy and fusion. Arnold, P. M., Vaccaro, A. R., Sasso, R. C., Goulet, B., Fehlings, M. G., Heary, R. F., Janssen, M. E., Kopjar, B. 2022
Assessing Postoperative Pseudarthrosis in Anterior Cervical Discectomy and Fusion (ACDF) on Dynamic Radiographs Using Novel Angular Measurements. Balouch, E., Burapachaisri, A., Woo, D., Norris, Z., Segar, A., Ayres, E. W., Vasquez-Montes, D., Buckland, A. J., Razi, A., Smith, M. L, Protopsaltis, T. S., Kim, Y. H. 2022
Diffusion basis spectrum imaging predicts long-term clinical outcomes following surgery in cervical spondylotic myelopathy. Zhang, J. K., Jayasekera, D., Javeed, S., Greenberg, J. K., Blum, J., Dibble, C. F., Sun, P., Song, S. K., Ray, W. Z. 2022
Utility of diffusion basis spectrum imaging in quantifying baseline disease severity and prognosis of cervical spondylotic myelopathy. Zhang, J. K., Sun, P., Jayasekera, D., Greenberg, J. K., Javeed, S., Dibble, C. F., Blum, J., Song, C., Song, S. K., Ray, W. Z. 2022
Predicting postoperative recovery in cervical spondylotic myelopathy: construction and interpretation of T2*-weighted radiomic-based extra trees models. Zhang, M. Z., Ou-Yang, H. Q., Liu, J. F., Jin, D., Wang, C. J., Ni, M., Liu, X. G., Lang, N., Jiang, L., Yuan, H. S. 2022
A randomized controlled trial for the intervention effect of early exercise therapy on axial pain after cervical laminoplasty Uehara, T., Tsushima, E., Yamada, S., Kimura, S., Satsukawa, Y., Yoshihara, A., Inada, A., Hayakawa, T. 2022
Long-term evaluation of cervical disc arthroplasty with the Mobi-C cervical disc: a randomized, prospective, multicenter clinical trial with seven-year follow-up Radcliff, K., R. J. Davis, M. S. Hisey, P. D. Nunley, G. A. Hoffman, R. J. Jackson, et al. 2017
The safety and efficacy of cervical laminectomy and fusion versus cervical laminoplasty surgery in degenerative cervical myelopathy: a prospective randomized trial Elmallawany, M., Kandel, H., Soliman, M. A. R. ,Tareef, T. A., Atallah, A. Elsaid, A., Elmahdy, W. 2020
Anterior or posterior foraminotomy for unilateral cervical radiculopathy Ebrahim, K. S. , El-Shehaby, A. Darwish, A. Faisa A. and Ma'Moun, E. 2011
Postoperative rigid cervical collar leads to less axial neck pain in the early stage after open-door laminoplasty-a single-blinded randomized controlled trial Cheung, J. P. Y., Cheung, P. W. H., Law, K., Borse, V., Lau, Y.M., Mak, L.F., Cheng, A., Samartzis, D., Cheung, K.M.C. 2019
Comparative study of artificial cervical disc replacement and anterior cervical discectomy/fusion in the treatment of cervical spondylotic myelopathy Chen, X., Shi, L., Yu, X., Pang, Q., Yang, J. 2019

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