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Purpose <p>This study compared complication rates between young adult patients undergoing anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) at time intervals up to five years.</p> Methods <p>The TriNetX database was used to perform a retrospective cohort analysis of patients between 18 and 60 years old who had undergone either ACDF or CDA. Propensity score matching (1:1) was performed based on demographic data and medical comorbidities. Patients with a prior history of cancer, ankylosing spondylitis, infectious or inflammatory bone conditions were excluded. Complication rates were analyzed and risk ratios with 95% confidence intervals were calculated up to five years postoperatively.</p> Results <p>There were 6,455 patients included in each treatment group at a mean age of 43 ± 8 years. At thirty days postoperatively, patients in the ACDF cohort had higher rates of dysphagia, deep vein thrombosis, and increased healthcare utilization metrics including hospital readmissions, emergency department utilization, and opioid utilization. At one, two, and five years, patients in the ACDF cohort demonstrated higher rates of anterior revision, posterior fusion, and post-laminectomy syndrome when compared with patients in the CDA cohort.</p> Conclusion <p>ACDF was associated with higher rates of postoperative complications compared to CDA in a young adult patient population. Within the limitations of a retrospective analysis, these findings suggest CDA may afford a safe motion-preserving alternative during the surgical management of cervical disc disease.</p>

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Cervical disc arthroplasty versus anterior cervical discectomy and fusion in the young adult patient population: A propensity-matched cohort study

  • 期刊论文

  • 发表日期：

    2026年2月21日

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  • Jason Silvestre,
  • Robert J. Ferdon,
  • Aidan Gillespie,
  • Sydney Seeger,
  • Warren Roth,
  • James P. Lawrence,
  • Charles A. Reitman,
  • Robert A. Ravinsky

摘要

Purpose

This study compared complication rates between young adult patients undergoing anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) at time intervals up to five years.

Methods

The TriNetX database was used to perform a retrospective cohort analysis of patients between 18 and 60 years old who had undergone either ACDF or CDA. Propensity score matching (1:1) was performed based on demographic data and medical comorbidities. Patients with a prior history of cancer, ankylosing spondylitis, infectious or inflammatory bone conditions were excluded. Complication rates were analyzed and risk ratios with 95% confidence intervals were calculated up to five years postoperatively.

Results

There were 6,455 patients included in each treatment group at a mean age of 43 ± 8 years. At thirty days postoperatively, patients in the ACDF cohort had higher rates of dysphagia, deep vein thrombosis, and increased healthcare utilization metrics including hospital readmissions, emergency department utilization, and opioid utilization. At one, two, and five years, patients in the ACDF cohort demonstrated higher rates of anterior revision, posterior fusion, and post-laminectomy syndrome when compared with patients in the CDA cohort.

Conclusion

ACDF was associated with higher rates of postoperative complications compared to CDA in a young adult patient population. Within the limitations of a retrospective analysis, these findings suggest CDA may afford a safe motion-preserving alternative during the surgical management of cervical disc disease.