Bottom line:
- ACDFusion vs ACDArthoplasty:
- 5 yrs after surgery:
- Similar clinical results (NDI, arm pain, Neck pain)
- ACDA does not have less reoperations at adjacent level
- ACDF
- Cheaper
- Shorter surgery
- Less complex
- Do not perform ACDiscectomy only (no implants)
- Worse clinical outcome (not statistically significant but trending towards it)
- Higher risk of index level re-operations 2.6% per year over 5 years where as ACDA and ACDF is 0.6% per year over 5 years.
- Hypothesis: caused by delayed fusion
- Emphasis on need for focus on timely fusion in future research
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