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Arthroplasty versus fusion in single-level cervical degenerative disc disease


Boselle, T.F.M., et al

Subject Keywords: Arthroplasty, Fusion, Radiculopathy, Myelopathy, Cervical degenerative disc disease
Type: Article
Region: International (other)

A herniated disc in the neck often causes radiating pain, numbness, and weakness in muscles of the neck, shoulders, arms, and hands. It may also lead to symptoms in the trunk and legs.

When there is no or insufficient relief of symptoms with non-surgical treatment, surgery can be an option. Traditional 'fusion' surgery involves fusion of the two bones of the spine (the vertebrae) that form the disc space. Motion between these two vertebrae is then no longer possible.

It has been suggested that this may cause the adjacent parts of the spine to become more mobile, as compensation. This in turn might accelerate normal wear and tear in these parts of the spine, which could lead to new symptoms. At present this is not confirmed.

Mobile disc prostheses have been introduced in an effort to reduce the amount of new symptoms at the longer term after surgery by preserving motion between the vertebrae involved. Long-term results are not available yet. However, it is important to know whether disc arthroplasty is at least as effective as fusion in relieving symptoms, the primary aim of surgery.

In this review the authors have searched for all studies in which the patient receives one of these two possible treatments at random.

They identified nine studies (2400 participants), and considered five of these to have high methodological quality. This review shows that patients who were treated with a mobile disc prosthesis had less pain radiating to the arm one to two years after surgery, and less disability owing to these complaints. However, the actual differences were very small, only between 1 and 5 points on a 100-point scale. The overall quality of the evidence was low to moderate, which means that including new studies in future years could change these conclusions. The conclusion that mobility is in fact preserved after placement of a mobile disc prosthesis, compared to traditional 'fusion' surgery, is unlikely to change. Whether this preserved mobility will lead to fewer new symptoms in the future is uncertain based on results for the first one to two years after surgery.



Rights: © The Cochrane Collaboration
Suggested citation:

Boselle, T.F.M., et al. (2012) Arthroplasty versus fusion in single-level cervical degenerative disc disease [Online]. Available from: [Accessed: 22nd July 2018].


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