. 2020 Mar;6(1):217–232. doi: 10.21037/jss.2019.12.09

Table 2. Descriptive summary of eligible randomized trials of CDA versus ACDF for one- or two-level symptomatic cervical spondylosis.

Author (year)	Trial	Enrollment	Population	Intervention	Control	Outcomes	Last follow-up	Sponsor/funding
One-level
Heller et al. [2009] (12); Sasso et al. [2011] (13); Ghobrial et al. [2019] (14); Lavelle et al. [2019] (8)	Bryan, US FDA IDE	May 2002–October 2004	N=463	N=242	N=221	NDI	10 years	Industry: Medtronic
			30 centers	CDA (Bryan)	ACDF with allograft and anterior plate	SF-36
			One-level spondylosis			Neck/arm pain VAS
			Radiculopathy or myelopathy			Neurological exam
			Refractory to 6 weeks of non-operative therapy, except myelopathy requiring immediate treatment			Work status
			Mean age: 44.4 yrs (CDA); 44.7 yrs (ACDF)			Adverse events
						Angular motion
Zhang et al. [2012] (15)	Bryan, China	May 2004–May 2006	N=109	N=56	N=53	NDI	2 years	Non-industry: Chinese Medical Doctor Association
			3 centers	CDA (Bryan)	ACDF with allograft and anterior plate	Neck/arm pain VAS
			One-level spondylosis, C3-7			ROM
			Radiculopathy or myelopathy			Adverse events
			Refractory to 6 weeks of non-operative therapy
			Mean age: 44.8 yrs (CDA); 45.6 yrs (ACDF)
Coric et al. [2011] (7); Coric et al. [2018] (16)	Kineflex\|C, US FDA IDE	July 2005–January 2010	N=269	N=136	N=133	NDI	5 years	Industry: SpinalMotion
			21 centers	CDA (Kineflex\|C)	ACDF with allograft and anterior plate	Neck pain VAS
			One-level spondylosis			Patient satisfaction
			Radiculopathy			Neurological exam
			Mean age: 43.7 yrs (CDA); 43.9 yrs (ACDF)			Adverse events
						Radiographic ASD
						Angular motion
						Activity level
Hisey et al. [2014] (17); Hisey et al. [2015] (18); Hisey et al. [2016] (19); Jackson et al. [2016] (6); Radcliff et al. [2017] (20)	Mobi-C, US FDA IDE	April 2006–March 2008	N=245	N=164	N=81	NDI	7 years	Industry: LDR Spine
			23 centers	CDA (Mobi-C)	ACDF with allograft and anterior plate	SF-12
			One-level spondylosis, C3-7			Angular motion
			Radiculopathy or myeloradiculopathy			Neurological exam
			Refractory to non-operative therapy for 6 weeks or progressive symptoms			Adverse events
			Mean age: 43.3 yrs (CDA); 44.0 yrs (ACDF)
Zhang et al. [2014] (21)	Mobi-C, China	February 2008–November 2009	N=111	N=55	N=56	JOA	4 years	None
			11 centers	CDA (Mobi-C)	ACDF with cage and anterior plate	NDI
			One-level spondylosis, C3-7			Neck pain VAS
			Symptomatic			ROM
			Refractory to 3 months of non-operative therapy			Adverse events
			Mean age: 44.8 yrs (CDA); 46.7 yrs (ACDF)
Phillips et al. [2013] (25); Phillips et al. [2015] (26)	PCM, US FDA IDE	January 2005-December 2007	N=403	N=218	N=185	NDI	7 years	Industry: NuVasive
			One-level spondylosis, C3-4 to C7-T1	CDA (PCM)	ACDF with allograft and anterior plate	SF-36
			Radiculopathy or myelopathy			Neck/arm pain VAS
			Refractory to non-operative therapy			Neurological status
			May have undergone prior nonadjacent or adjacent single-level fusion			Adverse events
						Angular motion
Mummaneni et al. [2007] (30); Burkus et al. [2010] (31); Burkus et al. [2014] (32)	Prestige ST, US FDA IDE	October 2002–August 2004	N=541	N=276	N=265	NDI	7 years	Industry: Medtronic
			32 centers	CDA (Prestige ST)	ACDF with allograft and anterior plate	Neck/arm pain VAS
			One-level spondylosis, C3-7			SF-36
			Radiculopathy or myelopathy			Neurological exam
			Refractory to non-operative therapy (≥6 weeks) or progressive neurological worsening			Work status
						ROM
						Adverse events
						Secondary surgery
Murrey et al. [2009] (33); Delamarter et al. [2010] (34); Zigler et al. [2013] (36); Delamarter & Zigler [2013] (35); Janssen et al. [2015] (37)	ProDisc-C, US FDA IDE	August 2003–October 2004	N=209	N=103	N=106	NDI	7 years	Industry: Synthes
			13 centers	CDA (ProDisc-C)	ACDF with allograft and anterior plate	Neck/arm pain VAS
			One-level spondylosis, C3-7			Patient satisfaction
			Radiculopathy			Neurological exam
			Refractory to non-operative therapy for at least 6 weeks			SF-36
			Mean age: 42.1 yrs (CDA); 43.5 yrs (ACDF)			Adverse events
						Angular motion
Vaccaro et al. [2013]; Vaccaro et al. [2018] (38,39)	Secure-C, US FDA IDE	July 2005–April 2008	N=291	N=151	N=140	NDI	7 years	Industry: Globus Medical
			18 centers	CDA (Secure-C)	ACDF with allograft and anterior plate	Neck/arm pain VAS
			One-level spondylosis, C3-7			Neurological status
			Radiculopathy or myelopathy			SF-36
			Refractory to non-operative therapy (≥6 weeks)			Range of motion
			Mean age: 43.4 yrs (CDA); 44.4 yrs (ACDF)
Two-level
Davis et al. [2013] (22); Davis et al. [2015] (23); Jackson et al. [2016] (6); Radcliff et al. [2016] (24); Radcliff et al. [2017] (20)	Mobi-C, US FDA IDE	April 2006–March 2008	N=330	N=225	N=105	NDI	7 years	Industry: LDR Medical
			24 centers	CDA (Mobi-C)	ACDF with allograft and anterior plate	SF-12
			Cervical spondylosis at two contiguous levels, C3-7			Angular motion
			Radiculopathy or myeloradiculopathy			Neurological exam
			Refractory to 6 weeks of non-operative therapy			Adverse events
			Mean age: 45.3 yrs (CDA); 46.2 yrs (ACDF)
Gornet et al. [2017] (27); Lanman et al. [2017] (28); Gornet et al. [2019] (29)	Prestige LP, US FDA IDE	June 2006–November 2007	N=397	N=209	N=188	NDI	10 years	Industry: Medtronic
			30 centers	CDA (Prestige LP)	ACDF with allograft and anterior plate	Neck/arm pain VAS
			Cervical spondylosis at two contiguous levels, C3-7			SF-36
			Refractory to 6 weeks of non-operative therapy			Gait abnormality
			Mean age: 47.1 yrs (CDA); 47.3 yrs (ACDF)			ROM
						Neurological exam
						Adverse events

ACDF, anterior cervical discectomy and fusion; CDA, cervical disc arthroplasty; JOA, Japanese Orthopaedic Association score; NDI, Neck Disability Index; ROM, range of motion; SF-12, Short-Form 12; SF-36, Short-Form 36; VAS, visual analog scale.