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Bias in cervical total disc replacement trials
#MMPMID28337733
Radcliff K
; Siburn S
; Murphy H
; Woods B
; Qureshi S
Curr Rev Musculoskelet Med
2017[Jun]; 10
(2
): 170-176
PMID28337733
show ga
PURPOSE OF REVIEW: Cervical disc replacement (CDR) has emerged as a
motion-preserving alternative to anterior cervical discectomy and fusion in
selected cases. Despite favorable literature, CDR is not universally accepted
because of concerns regarding bias in the existing literature. The purpose of
this review is to identify the possible biases in the disc replacement
literature. RECENT FINDINGS: Recent studies that compare CDR and ACDF have
demonstrated equivalent or superior outcomes, lower rates of secondary surgery,
and equivalent safety at medium- and long-term follow-up. In our review, we
identified four types of bias that may affect the CDR literature: publication
bias, external validity, confounding bias, and financial conflicts of interest.
Bias, whether intentional or unintentional, can impact the interpretation and
outcome of CDR studies. Recognition of this issue is critical when utilizing the
existing literature to determine the efficacy of CDR and designing future
studies.
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