PMID- 28032703
OWN - NLM
STAT- MEDLINE
DCOM- 20170317
LR  - 20220316
IS  - 1757-7861 (Electronic)
IS  - 1757-7853 (Print)
IS  - 1757-7853 (Linking)
VI  - 8
IP  - 4
DP  - 2016 Nov
TI  - Comparison of Anterior Cervical Discectomy and Fusion versus Posterior Cervical 
      Foraminotomy in the Treatment of Cervical Radiculopathy: A Systematic Review.
PG  - 425-431
LID - 10.1111/os.12285 [doi]
AB  - Controversy remains over whether anterior cervical discectomy and fusion (ACDF) 
      or posterior cervical foraminotomy (PCF) is superior for the treatment of 
      cervical radiculopathy. We therefore performed a systematic review including 
      three prospective randomized controlled trails (RCT) and seven retrospective 
      comparative studies (RCoS) by searching PubMed and EMBASE. These studies were 
      assessed on risk of bias according to the Cochrane Handbook for Systematic 
      Reviews of Interventions, and the quality of evidence and level of recommendation 
      were evaluated according to the GRADE approach. Clinical outcomes, complications, 
      reoperation rates, radiological parameters, and cost/cost-utility were evaluated. 
      The mean complication rate was 7% in the ACDF group and 4% in the PCF group, and 
      the mean reoperation rate was 4% in the ACDF group and 6% in the PCF group within 
      2 years of the initial surgery. There was a strong level of recommendation that 
      no difference existed in clinical outcome, complication rate and reoperation rate 
      between the ACDF and the PCF group. There was conflicting evidence that the ACDF 
      group had better clinical outcomes than the PCF group (one study with weak level 
      of recommendation). PCF could preserve the range of motion (ROM) of the operated 
      segment but did not increase the ROM of the adjacent segment (weak level of 
      recommendation). Meanwhile, the average cost or cost-utility of the PCF group was 
      significantly lower than that of the ACDF group (weak level of recommendation). 
      In conclusion, the PCF was just as safe and effective as the ACDF in the 
      treatment of cervical radiculopathy. Meanwhile, PCF might have lower medical cost 
      than ACDF and decrease the incidence of adjacent segment disease. Based on the 
      available evidence, PCF appears to be another good surgical approach in the 
      treatment of cervical radiculopathy.
CI  - (c) 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.
FAU - Liu, Wei-Jun
AU  - Liu WJ
AD  - Department of Orthopaedics, Pu Ai Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, China.
FAU - Hu, Ling
AU  - Hu L
AD  - Department of Anesthesiology, Tianyou Hospital, Wuhan University of Science and 
      Technology, Wuhan, China.
FAU - Chou, Po-Hsin
AU  - Chou PH
AD  - Department of Orthopaedics and Traumatology, Taipei Veterans General, Hospital 
      School of Medicine, National Yang-Ming University, Taipei, Taiwan.
FAU - Wang, Jun-Wen
AU  - Wang JW
AD  - Department of Orthopaedics, Pu Ai Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, China.
FAU - Kan, Wu-Sheng
AU  - Kan WS
AD  - Department of Orthopaedics, Pu Ai Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - Australia
TA  - Orthop Surg
JT  - Orthopaedic surgery
JID - 101501666
SB  - IM
MH  - Cervical Vertebrae/*surgery
MH  - *Diskectomy
MH  - *Foraminotomy
MH  - Humans
MH  - Radiculopathy/*surgery
MH  - *Spinal Fusion
MH  - Treatment Outcome
PMC - PMC6584082
OTO - NOTNLM
OT  - Anterior cervical discectomy and fusion
OT  - Cervical radiculopathy
OT  - Posterior cervical foraminotomy
OT  - Systematic review
EDAT- 2016/12/30 06:00
MHDA- 2017/03/18 06:00
PMCR- 2016/12/29
CRDT- 2016/12/30 06:00
PHST- 2016/03/06 00:00 [received]
PHST- 2016/03/21 00:00 [accepted]
PHST- 2016/12/30 06:00 [entrez]
PHST- 2016/12/30 06:00 [pubmed]
PHST- 2017/03/18 06:00 [medline]
PHST- 2016/12/29 00:00 [pmc-release]
AID - OS12285 [pii]
AID - 10.1111/os.12285 [doi]
PST - ppublish
SO  - Orthop Surg. 2016 Nov;8(4):425-431. doi: 10.1111/os.12285.