Study Summary

12 randomized controlled trials including 2612 patients with cervical spondylotic myelopathy were included in comparing cervical disc arthroplasty versus anterior cervical discectomy and fusion. Pooled outcomes of interest included overall success, Neck Disability Index (NDI), visual analog scale scores for neck and arm pain, neurological success, range of motion (ROM), quality of life (SF-36), adverse events, reoperation rates, operative time, and blood loss. Overall, cervical disc arthroplasty demonstrated significantly higher overall success, improved neck pain and disability scores at multiple follow-up intervals, and lower adjacent-level reoperation rates, although operative time was longer. These findings suggest cervical disc arthroplasty may provide modest clinical advantages with comparable safety relative to fusion for treatment of cervical spondylotic myelopathy.