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Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of multilevel cervical spondylotic myelopathy: systematic review and a meta-analysis.

Wen ZQ, Du JY, Ling ZH, Xu HD, Lin XJ - Ther Clin Risk Manag (2015)

Bottom Line: We determined the pooled data, data heterogeneity, and overall effect, respectively.We found that blood loss and numbers of complications during surgery in ACDF were significantly less that in ACCF; however, other clinical outcomes, such as operation time, bone fusion failure, post Japanese Orthopedic Association scores, recovery rates, and visual analog scale scores between ACDF and ACCF with multilevel CSM were not significantly different.Our results strongly suggest that surgical treatments of multilevel CSM are similar in terms of most clinical outcomes using ACDF or ACCF.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.

ABSTRACT

Background: To date, the decision to treat multilevel cervical spondylotic myelopathy (CSM) with anterior cervical discectomy and fusion (ACDF) or anterior cervical corpectomy and fusion (ACCF) remains controversial. Therefore, we conducted a meta-analysis to quantitatively determine the efficacy of ACDF and ACCF in the treatment of multilevel CSM.

Methods: We searched several databases for related research articles published in English or Chinese. We extracted and assessed the data independently. We determined the pooled data, data heterogeneity, and overall effect, respectively.

Results: We identified 15 eligible studies with 1,368 patients. We found that blood loss and numbers of complications during surgery in ACDF were significantly less that in ACCF; however, other clinical outcomes, such as operation time, bone fusion failure, post Japanese Orthopedic Association scores, recovery rates, and visual analog scale scores between ACDF and ACCF with multilevel CSM were not significantly different.

Conclusion: Our results strongly suggest that surgical treatments of multilevel CSM are similar in terms of most clinical outcomes using ACDF or ACCF.

No MeSH data available.


Related in: MedlinePlus

(A) Comparison of recovery rates between ACDF and ACCF for the treatment of CSM. (B) Comparison of visual analog scale scores between ACDF and ACCF for the treatment of CSM.Abbreviations: ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; CSM, cervical spondylotic myelopathy; IV, independent variable; CI, confidence interval; SD, standard deviation.
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f7-tcrm-11-161: (A) Comparison of recovery rates between ACDF and ACCF for the treatment of CSM. (B) Comparison of visual analog scale scores between ACDF and ACCF for the treatment of CSM.Abbreviations: ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; CSM, cervical spondylotic myelopathy; IV, independent variable; CI, confidence interval; SD, standard deviation.

Mentions: We determined the recovery rates for five studies in a total of 384 CSM patients with ACDF or ACCF surgery. Heterogeneity analysis shows that I2 was 90%. The test for overall effect (Z=0.71, P=0.48) indicated that the recovery rates between ACDF and ACCF for CSM were not significantly different (Figure 7A). In addition, we also determined the VAS scores in four studies in a total of 236 CSM patients with ACDF or ACCF surgery. Heterogeneity analysis shows that I2 was 76%. The test for overall effect (Z=1.05, P=0.29) indicated that the VAS scores between ACDF and ACCF for CSM was not significantly different (Figure 7B).


Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of multilevel cervical spondylotic myelopathy: systematic review and a meta-analysis.

Wen ZQ, Du JY, Ling ZH, Xu HD, Lin XJ - Ther Clin Risk Manag (2015)

(A) Comparison of recovery rates between ACDF and ACCF for the treatment of CSM. (B) Comparison of visual analog scale scores between ACDF and ACCF for the treatment of CSM.Abbreviations: ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; CSM, cervical spondylotic myelopathy; IV, independent variable; CI, confidence interval; SD, standard deviation.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4321642&req=5

f7-tcrm-11-161: (A) Comparison of recovery rates between ACDF and ACCF for the treatment of CSM. (B) Comparison of visual analog scale scores between ACDF and ACCF for the treatment of CSM.Abbreviations: ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; CSM, cervical spondylotic myelopathy; IV, independent variable; CI, confidence interval; SD, standard deviation.
Mentions: We determined the recovery rates for five studies in a total of 384 CSM patients with ACDF or ACCF surgery. Heterogeneity analysis shows that I2 was 90%. The test for overall effect (Z=0.71, P=0.48) indicated that the recovery rates between ACDF and ACCF for CSM were not significantly different (Figure 7A). In addition, we also determined the VAS scores in four studies in a total of 236 CSM patients with ACDF or ACCF surgery. Heterogeneity analysis shows that I2 was 76%. The test for overall effect (Z=1.05, P=0.29) indicated that the VAS scores between ACDF and ACCF for CSM was not significantly different (Figure 7B).

Bottom Line: We determined the pooled data, data heterogeneity, and overall effect, respectively.We found that blood loss and numbers of complications during surgery in ACDF were significantly less that in ACCF; however, other clinical outcomes, such as operation time, bone fusion failure, post Japanese Orthopedic Association scores, recovery rates, and visual analog scale scores between ACDF and ACCF with multilevel CSM were not significantly different.Our results strongly suggest that surgical treatments of multilevel CSM are similar in terms of most clinical outcomes using ACDF or ACCF.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.

ABSTRACT

Background: To date, the decision to treat multilevel cervical spondylotic myelopathy (CSM) with anterior cervical discectomy and fusion (ACDF) or anterior cervical corpectomy and fusion (ACCF) remains controversial. Therefore, we conducted a meta-analysis to quantitatively determine the efficacy of ACDF and ACCF in the treatment of multilevel CSM.

Methods: We searched several databases for related research articles published in English or Chinese. We extracted and assessed the data independently. We determined the pooled data, data heterogeneity, and overall effect, respectively.

Results: We identified 15 eligible studies with 1,368 patients. We found that blood loss and numbers of complications during surgery in ACDF were significantly less that in ACCF; however, other clinical outcomes, such as operation time, bone fusion failure, post Japanese Orthopedic Association scores, recovery rates, and visual analog scale scores between ACDF and ACCF with multilevel CSM were not significantly different.

Conclusion: Our results strongly suggest that surgical treatments of multilevel CSM are similar in terms of most clinical outcomes using ACDF or ACCF.

No MeSH data available.


Related in: MedlinePlus