Early Motion Preservation but Converging Two-year Outcomes After Cervical Disc Arthroplasty Versus Anterior Cervical Discectomy and Fusion: a Retrospective Cohort Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: This study compared cervical alignment, pain, cervical range of motion (ROM), and implant-related radiological findings between singlelevel anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA). Materials and Methods:This retrospective comparative cohort study included 96 patients who underwent single-level anterior cervical surgery between 2015 and 2024, of whom 50 underwent ACDF and 46 underwent CDA.Sagittal and coronal cervical Cobb angles, visual analog scale (VAS) pain scores, total cervical ROM, and directional movements were assessed preoperatively and at 6 months, 1 year, and 2 years postoperatively.Implant-related bone changes and heterotopic ossification were evaluated.Between-group comparisons were analyzed using independentsamples t-tests and Fisher's exact tests, whereas longitudinal changes were analyzed using linear mixed-effects models.Results: Sagittal and coronal Cobb angles did not differ significantly between the groups at any time point.VAS pain scores improved significantly over time in both groups, without a significant between-group difference.Total cervical ROM decreased to a lesser extent after CDA than after ACDF at 6 months and 1 year (both p<0.001), but not at 2 years (p=0.623).Similar early-and mid-term advantages were observed for flexion, extension, and bilateral lateral flexion.Significant group-by-time interactions were identified for total ROM and directional movements.Most implant-related radiological findings were comparable between the groups; however, segmental collapse was significantly more frequent after ACDF than after CDA (20.0% vs. 2.2%; p=0.008).In the CDA group, grade III heterotopic ossification occurred in 8.7% of patients, and grade IV functional fusion occurred in 4.3% of patients.Conclusion: ACDF and CDA provided comparable pain relief and cervical alignment outcomes.CDA better preserved cervical mobility during early and midterm follow-up; however, this advantage was not maintained at 2 years.Segmental collapse was less frequent after CDA, although larger studies are required to confirm differences in implant-related complications.
Authors: Merdan Orunoğlu, Mehmet Meral, Soner Yaşar
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7221748599