Artificial Cervical Disc Arthroplasty
Bibliographic record
Abstract
In Brief Study Design. Systematic Review. Objective. (1) To qualitatively analyze the literature on the efficacy and effectiveness of artificial cervical disc arthroplasty (ACDA). (2) To highlight methodological and reporting issues of randomized controlled trials (RCT) reports on effectiveness of ACDA compared to cervical fusion. Summary of Background Data. ACDA is an alternate surgical procedure that may replace cervical fusion in selected patients suffering from cervical degenerative disc disease. Methods. We searched seven electronic databases, including MEDLINE, Cochrane Library, and EMBASE, unpublished sources, and reference lists for studies on the efficacy and effectiveness of ACDA compared to cervical fusion—the surgical standard of care for patients with cervical degenerative disc disease. Results. A total of 622 studies were retrieved, of which 18 (13 case series, four RCT reports, one nonrandomized comparative study) met the inclusion criteria for this review. The four RCTs and the nonrandomized comparative study concluded that the effectiveness of ACDA is not inferior to that of cervical fusion in the short term (up to 2-yr follow-up). The safety profile of both procedures appears similar. The case series reviewed noted improved clinical outcomes at 1 or 2 years after one or multiple-level ACDA. Conclusion. ACDA is a surgical procedure that may replace cervical fusion in selected patients suffering from cervical degenerative disc disease. Within 2 years of follow-up, the effectiveness of ACDA appears similar to that of cervical fusion. Weak evidence exists that ACDA may be superior to fusion for treating neck and arm pain. Future studies should report change scores and change score variance in accordance with RCT guidelines, in order to strengthen credibility of conclusions and to facilitate meta-analyses of studies. This systematic review of studies on the effectiveness of artificial cervical disc arthroplasty compared to cervical fusion concluded that artificial cervical disc arthroplasty appears to be at least as effective as cervical fusion in the short term. Further, RCTs should adhere to reporting guidelines, in order to strengthen credibility of conclusions and to facilitate meta-analyses of studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.058 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.015 | 0.009 |
| Bibliometrics | 0.016 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.019 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".