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September 2, 2026Global Spine Journal0 citationsOpen Access

Long-Term Outcomes of ACDF, Disc Arthroplasty, and Foraminotomy for Cervical Radiculopathy

Long-Term Comparative Outcomes of ACDF, Cervical Disc Arthroplasty, and Posterior Cervical Foraminotomy for Single-Level Cervical Radiculopathy: A Propensity-Matched Analysis

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Authors

MMMark MillerRNRuchir NanavatiMMMatthew Meade

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Overview

Retrospective cohort study demonstrates higher reoperation rates after posterior cervical foraminotomy in cervical radiculopathy, highlighting distinct long-term surgical trade-offs.

Key Points

  • To compare long-term reoperation rates, complications, and healthcare utilization among anterior cervical discectomy and fusion (ACDF), cervical disc arthroplasty (CDA), and posterior cervical foraminotomy (PCF) for single-level cervical radiculopathy.
  • Conducted a retrospective cohort study using the TriNetX database of adult patients undergoing single-level ACDF, CDA, or PCF for cervical radiculopathy.
  • Formed 1:1 propensity-matched cohorts: ACDF vs. PCF (N=2,659), ACDF vs. CDA (N=3,749), and CDA vs. PCF (N=2,143).
  • Evaluated perioperative complications, emergency department visits, intensive care unit admissions, and reoperation rates from 30 days to 5 years.
  • PCF demonstrated significantly higher reoperation rates at all timepoints compared to both ACDF and CDA, including at 5 years (PCF 9.5% vs. ACDF 4.4%, p<0.001; PCF 10.0% vs. CDA 2.8%, p<0.001).
  • CDA showed a significantly lower 5-year reoperation rate compared to ACDF (3.2% vs. 4.5%, p=0.01).
  • ACDF was associated with significantly higher rates of early emergency department visits and intensive care unit admissions compared with CDA.

Cite This Study

Miller et al. (2026) studied this question.

synapsesocial.com/papers/6a97e2c5c562ede874ec70d0https://doi.org/10.1177/21925682261486009
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