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. 2020 Jun 1;15(1):202.
doi: 10.1186/s13018-020-01723-5.

Anterior cervical discectomy and fusion versus posterior cervical foraminotomy for the treatment of single-level unilateral cervical radiculopathy: a meta-analysis

Wenguang Fang  1 , Lijun Huang  2 , Feng Feng  2 , Bu Yang  2 , Lei He  2 , Guizhong Du  1 , Peigen Xie  3 , Zihao Chen  4
Affiliations

Anterior cervical discectomy and fusion versus posterior cervical foraminotomy for the treatment of single-level unilateral cervical radiculopathy: a meta-analysis

Wenguang Fang et al. J Orthop Surg Res. .

Abstract

Background: To compare the effectiveness and safety of anterior cervical discectomy and fusion (ACDF) with posterior cervical foraminotomy (PCF) for patients diagnosed with single-level unilateral cervical radiculopathy.

Methods: Relevant studies comparing ACDF with PCF for cervical radiculopathy were searched in an electronic database. After data extraction and quality assessment of included studies, a meta-analysis was done by using the RevMan 5.3 software. The random effects model was used if there was heterogeneity between studies; otherwise, the fixed effects model was used.

Results: A total of 3 randomized controlled trials (RCT) and 12 retrospective studies including 52705 patients were included in the meta-analysis. There were no significant differences in Neck Disability Index (NDI), Visual Analog Scale (VAS), and patients' satisfaction (P > 0.05) between treatment groups. The complication rate of the PCF group was equivalent compared with the ACDF group (P = 0.60), but the reoperation rate following PCF was on the higher side (P = 0.02). Data analysis also showed that the PCF group was associated with shorter operation time (P = 0.001) and shorter length of hospital stay (P = 0.002).

Conclusions: Among patients with single-level unilateral cervical radiculopathy, PCF has comparable effectiveness and complication rate compared with ACDF. It seems that PCF is a sufficient alternative procedure with shorter operation time, shorter length of hospital stay, and less total hospital cost for the treatment of cervical radiculopathy. However, the higher reoperation rate following PCF should be also taken into consideration.

Keywords: Anterior cervical discectomy and fusion; Cervical radiculopathy; Meta-analysis; Posterior cervical foraminotomy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection
Fig. 2
Fig. 2
Forest plot of NDI between the ACDF group and PCF group
Fig. 3
Fig. 3
Forest plot of VAS-neck between the ACDF group and PCF group
Fig. 4
Fig. 4
Forest plot of VAS-arm between the ACDF group and PCF group
Fig. 5
Fig. 5
Forest plot of patient satisfaction between the ACDF group and PCF group
Fig. 6
Fig. 6
Forest plot of overall complication rate between the ACDF group and PCF group
Fig. 7
Fig. 7
Forest plot of overall reoperation rate between the ACDF group and PCF group
Fig. 8
Fig. 8
Forest plot between the ACDF group and PCF group for a operation time, b intraoperative blood loss, and c length of hospital stay
See this image and copyright information in PMC

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