ACDF vs TDR

1. EBS
Salem Al-Dwairy
Spine fellow: Macquarie
Neurosurgery.
Macquarie university.
September, 2015

2. • 55years old.
• Neck pain + severe left arm pain
for three months.
• Not responding to conservative
treatment.
ACDF Vs TDR.

3. PICO: Fusion Vs disc replacement in patients
with cervical disc disease.
• P: Patients with cervical disc disease.
• I: Cervical fusion.
• C: Disc replacement.
• O: Treatment outcome.

4. Data bases:
• Medline.
• Embase.
• Scopus.

5. Medline

6. Medline

9. Embase

10. Scopus
• Cervical
• fusion or arthrodesis or ACDF .
• "disc replacement" or "disc arthroplasty" or TDR.
• randomi*ed or RCT or RCCT.

12. Medline 37 Embase 22 Scopus 146
205
Non RCTs
TDR or ACDF alone
Duplicates
< 2 years follow-up
Cost effectiveness/economic analysis
Biomechanical comparison
Non-English Journals
Non-comparative
Bone graft studies
Non-human
Lumbar spine
Hybrid surgery
Surgical technique
TDR after ACDF
??? ACDF/TDR Vs THR
37 RCT + 16 met analysis of RCT
Excluded
152

14. Met analyses

15. 10 RCTs
• Blinding.
• Sample size.
• Recent studies.
• ? Funding.
• Common to met recent analysis.

16. Conclusion
• TDR has better outcome in term of: neck VAS, C spine ROM and
reoperation rate.
• ACDF procedure have less operative time.
• TDR might have better outcome in : NDI, arm VAS, SF 36 and
dysphagia.

17. Contribution to knowledge