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Study design <p>Systematic review and meta-analysis.</p> Objectives <p>Motion preserving surgery for cervical radiculopathy treats lateral and foraminal disc pathology while causing minimal disruption to the stability of the cervical spine and include cervical disc arthroplasty (CDA) and minimally invasive posterior cervical foraminotomy (MI-PCF) including endoscopic PCF (PECF). This study aims to compare the functional and surgical outcomes between CDA and MI-PCF.</p> Methods <p>This study includes a systematic review of present literature and meta-analysis comparing motion preserving surgeries of CDA and MI-PCF for treatment of cervical radiculopathy.</p> Results <p>A total of 575 abstracts were reviewed and assessed and 7 comparative studies between MI-PCF and CDA were included. The mean operative time for patients undergoing CDA was between 38.7 and 110.1&#xa0;min, while the mean operative time for patients undergoing MI-PCF was between 35.9 and 108.3&#xa0;min, with MI-PCF being performed 3.4&#xa0;min faster than CDA. The overall complications rate was 5.4% for CDA and 3.4% for MI-PCF and the overall reoperation rate was 0.9% for CDA and 3.8% for PCF. A random effects model meta-analysis was carried out which showed no significant differences in complication rate but MI-PCF had significantly higher reoperation rates compared to CDA. Patients who underwent PCF had non-statistically significant improvement in functional outcomes of Neck Disability Index (NDI) and Visual Analogue Scale (VAS) neck and arm scores compared to patients who underwent CDA at 6 months postoperatively. Subsequently, patients who underwent MI-PCF had further improvement in NDI and VAS neck and arm scores 1 year post-operatively, with statistically significant improvements in scores compared to patients who underwent CDA. Subgroup analysis of functional outcomes comparing CDA and PECF showed non-statistically significant improvement in VAS scores but poorer NDI scores for patients undergoing PECF at 6 months post operation.</p> Conclusion <p>MI-PCF has lower complication rates and better short term functional outcomes compared to CDA despite also having higher reoperation rates. Further studies with longer follow up correlating functional outcomes with radiological parameters measuring cervical motion is required to establish its superiority over CDA.</p>

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Cervical disc arthroplasty versus minimally invasive posterior cervical procedures as motion preserving surgeries for cervical radiculopathy: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年2月27日

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  • Jia Yi Loh,
  • Xian Jun Ngoh,
  • Zhihong Chew,
  • Yee Gen Lim,
  • Michael Janssen,
  • Jiang Lei

摘要

Study design

Systematic review and meta-analysis.

Objectives

Motion preserving surgery for cervical radiculopathy treats lateral and foraminal disc pathology while causing minimal disruption to the stability of the cervical spine and include cervical disc arthroplasty (CDA) and minimally invasive posterior cervical foraminotomy (MI-PCF) including endoscopic PCF (PECF). This study aims to compare the functional and surgical outcomes between CDA and MI-PCF.

Methods

This study includes a systematic review of present literature and meta-analysis comparing motion preserving surgeries of CDA and MI-PCF for treatment of cervical radiculopathy.

Results

A total of 575 abstracts were reviewed and assessed and 7 comparative studies between MI-PCF and CDA were included. The mean operative time for patients undergoing CDA was between 38.7 and 110.1 min, while the mean operative time for patients undergoing MI-PCF was between 35.9 and 108.3 min, with MI-PCF being performed 3.4 min faster than CDA. The overall complications rate was 5.4% for CDA and 3.4% for MI-PCF and the overall reoperation rate was 0.9% for CDA and 3.8% for PCF. A random effects model meta-analysis was carried out which showed no significant differences in complication rate but MI-PCF had significantly higher reoperation rates compared to CDA. Patients who underwent PCF had non-statistically significant improvement in functional outcomes of Neck Disability Index (NDI) and Visual Analogue Scale (VAS) neck and arm scores compared to patients who underwent CDA at 6 months postoperatively. Subsequently, patients who underwent MI-PCF had further improvement in NDI and VAS neck and arm scores 1 year post-operatively, with statistically significant improvements in scores compared to patients who underwent CDA. Subgroup analysis of functional outcomes comparing CDA and PECF showed non-statistically significant improvement in VAS scores but poorer NDI scores for patients undergoing PECF at 6 months post operation.

Conclusion

MI-PCF has lower complication rates and better short term functional outcomes compared to CDA despite also having higher reoperation rates. Further studies with longer follow up correlating functional outcomes with radiological parameters measuring cervical motion is required to establish its superiority over CDA.