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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

The funnel plots are largely symmetrical, suggesting there is no publication bias in the meta-analysis of anterior cervical discectomy and fusion and anterior cervical corpectomy and fusion in the treatment of cervical spondylotic myelopathy.Notes: The funnel plot from seven studies comparing operation time (A). The funnel plot from seven studies comparing blood loss (B). The funnel plot from 14 studies comparing bone fusion failure (C). The funnel plot from ten studies comparing complications (D). The funnel plot from nine studies comparing post Japanese Orthopedic Association scores (E). The funnel plot from five studies comparing the recovery rates (F). The funnel plot from four studies comparing the visual analog scale scores (G).Abbreviations: SE, standard error; MD, mean difference.
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f8-tcrm-11-161: The funnel plots are largely symmetrical, suggesting there is no publication bias in the meta-analysis of anterior cervical discectomy and fusion and anterior cervical corpectomy and fusion in the treatment of cervical spondylotic myelopathy.Notes: The funnel plot from seven studies comparing operation time (A). The funnel plot from seven studies comparing blood loss (B). The funnel plot from 14 studies comparing bone fusion failure (C). The funnel plot from ten studies comparing complications (D). The funnel plot from nine studies comparing post Japanese Orthopedic Association scores (E). The funnel plot from five studies comparing the recovery rates (F). The funnel plot from four studies comparing the visual analog scale scores (G).Abbreviations: SE, standard error; MD, mean difference.

Mentions: A sensitivity analysis was conducted to assess the stability of our results. The pooled odds ratios or mean differences were not significantly changed, indicating the stability of our analyses. The funnel plots were largely symmetrical (Figure 8) suggesting that there was no publication bias in the meta-analysis of CSM patients with ACDF or ACCF surgery.


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)

The funnel plots are largely symmetrical, suggesting there is no publication bias in the meta-analysis of anterior cervical discectomy and fusion and anterior cervical corpectomy and fusion in the treatment of cervical spondylotic myelopathy.Notes: The funnel plot from seven studies comparing operation time (A). The funnel plot from seven studies comparing blood loss (B). The funnel plot from 14 studies comparing bone fusion failure (C). The funnel plot from ten studies comparing complications (D). The funnel plot from nine studies comparing post Japanese Orthopedic Association scores (E). The funnel plot from five studies comparing the recovery rates (F). The funnel plot from four studies comparing the visual analog scale scores (G).Abbreviations: SE, standard error; MD, mean difference.
© Copyright Policy
Related In: Results  -  Collection

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

f8-tcrm-11-161: The funnel plots are largely symmetrical, suggesting there is no publication bias in the meta-analysis of anterior cervical discectomy and fusion and anterior cervical corpectomy and fusion in the treatment of cervical spondylotic myelopathy.Notes: The funnel plot from seven studies comparing operation time (A). The funnel plot from seven studies comparing blood loss (B). The funnel plot from 14 studies comparing bone fusion failure (C). The funnel plot from ten studies comparing complications (D). The funnel plot from nine studies comparing post Japanese Orthopedic Association scores (E). The funnel plot from five studies comparing the recovery rates (F). The funnel plot from four studies comparing the visual analog scale scores (G).Abbreviations: SE, standard error; MD, mean difference.
Mentions: A sensitivity analysis was conducted to assess the stability of our results. The pooled odds ratios or mean differences were not significantly changed, indicating the stability of our analyses. The funnel plots were largely symmetrical (Figure 8) suggesting that there was no publication bias in the meta-analysis of CSM patients with ACDF or ACCF surgery.

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