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Meta-Analysis Comparing Zero-Profile Spacer and Anterior Plate in Anterior Cervical Fusion.

Dong J, Lu M, Lu T, Liang B, Xu J, Zhou J, Lv H, Qin J, Cai X, Huang S, Li H, Wang D, He X - PLoS ONE (2015)

Bottom Line: Compared to the anterior plate group, the Zero-P group exhibited a significantly improved JOA score and reduced NDI and VAS.However, the results of this meta-analysis should be accepted with caution due to the limitations of the study.Further evaluation and large-sample RCTs are required to confirm and update the results of this study.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.

ABSTRACT

Background: Anterior plate fusion is an effective procedure for the treatment of cervical spinal diseases but is accompanied by a high incidence of postoperative dysphagia. A zero profile (Zero-P) spacer is increasingly being used to reduce postoperative dysphagia and other potential complications associated with surgical intervention. Studies comparing the Zero-P spacer and anterior plate have reported conflicting results.

Methodology: A meta-analysis was conducted to compare the safety, efficacy, radiological outcomes and complications associated with the use of a Zero-P spacer versus an anterior plate in anterior cervical spine fusion for the treatment of cervical spinal disease. We comprehensively searched PubMed, Embase, the Cochrane Library and other databases and performed a meta-analysis of all randomized controlled trials (RCTs) and prospective or retrospective comparative studies assessing the two techniques.

Results: Ten studies enrolling 719 cervical spondylosis patients were included. The pooled data showed significant differences in the operation time [SMD = -0.58 (95% CI = -0.77 to 0.40, p < 0.01)] and blood loss [SMD = -0.40, 95% CI (-0.59 to -0.21), p < 0.01] between the two groups. Compared to the anterior plate group, the Zero-P group exhibited a significantly improved JOA score and reduced NDI and VAS. However, anterior plate fusion had greater postoperative segmental and cervical Cobb's angles than the Zero-P group at the last follow-up. The fusion rate in the two groups was similar. More importantly, the Zero-P group had a lower incidence of earlier and later postoperative dysphagia.

Conclusions: Compared to anterior plate fusion, Zero-P is a safer and effective procedure, with a similar fusion rate and lower incidence of earlier and later postoperative dysphagia. However, the results of this meta-analysis should be accepted with caution due to the limitations of the study. Further evaluation and large-sample RCTs are required to confirm and update the results of this study.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of literature search.
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pone.0130223.g001: Flow diagram of literature search.

Mentions: A total of 258 records were retrieved according to the search strategy. Among these, 124 records were identified through database searching (PubMed, n = 42; Ovid, n = 19; Embase, n = 63), and 134 additional records were identified via other sources (ISI Web of Science, n = 96; CBM, n = 17; Google Scholar, Scopus, Wanfang, n = 21). After review by title, abstract or full text, 248 reports were excluded for not meeting the inclusion criteria. Five full-text excluded studies and reasons for their exclusion are shown in S1 File. Finally, 10 eligible records were included in this study[16–20, 24–28] (Fig 1). The included studies were published between 2012 and 2014 and included 719 cervical spondylosis patients (Zero-P group, 343; Plate group, 376). The basic characteristics are summarized in Table 1. The statistically similar baseline between Zero-P and anterior plate groups is summarized in Table 2. The preoperative and postoperative evaluation data are summarized in Table 3and Table 4, respectively. Among the included studies were two small-sample RCTs, three prospective studies and five retrospective studies.


Meta-Analysis Comparing Zero-Profile Spacer and Anterior Plate in Anterior Cervical Fusion.

Dong J, Lu M, Lu T, Liang B, Xu J, Zhou J, Lv H, Qin J, Cai X, Huang S, Li H, Wang D, He X - PLoS ONE (2015)

Flow diagram of literature search.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4466022&req=5

pone.0130223.g001: Flow diagram of literature search.
Mentions: A total of 258 records were retrieved according to the search strategy. Among these, 124 records were identified through database searching (PubMed, n = 42; Ovid, n = 19; Embase, n = 63), and 134 additional records were identified via other sources (ISI Web of Science, n = 96; CBM, n = 17; Google Scholar, Scopus, Wanfang, n = 21). After review by title, abstract or full text, 248 reports were excluded for not meeting the inclusion criteria. Five full-text excluded studies and reasons for their exclusion are shown in S1 File. Finally, 10 eligible records were included in this study[16–20, 24–28] (Fig 1). The included studies were published between 2012 and 2014 and included 719 cervical spondylosis patients (Zero-P group, 343; Plate group, 376). The basic characteristics are summarized in Table 1. The statistically similar baseline between Zero-P and anterior plate groups is summarized in Table 2. The preoperative and postoperative evaluation data are summarized in Table 3and Table 4, respectively. Among the included studies were two small-sample RCTs, three prospective studies and five retrospective studies.

Bottom Line: Compared to the anterior plate group, the Zero-P group exhibited a significantly improved JOA score and reduced NDI and VAS.However, the results of this meta-analysis should be accepted with caution due to the limitations of the study.Further evaluation and large-sample RCTs are required to confirm and update the results of this study.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.

ABSTRACT

Background: Anterior plate fusion is an effective procedure for the treatment of cervical spinal diseases but is accompanied by a high incidence of postoperative dysphagia. A zero profile (Zero-P) spacer is increasingly being used to reduce postoperative dysphagia and other potential complications associated with surgical intervention. Studies comparing the Zero-P spacer and anterior plate have reported conflicting results.

Methodology: A meta-analysis was conducted to compare the safety, efficacy, radiological outcomes and complications associated with the use of a Zero-P spacer versus an anterior plate in anterior cervical spine fusion for the treatment of cervical spinal disease. We comprehensively searched PubMed, Embase, the Cochrane Library and other databases and performed a meta-analysis of all randomized controlled trials (RCTs) and prospective or retrospective comparative studies assessing the two techniques.

Results: Ten studies enrolling 719 cervical spondylosis patients were included. The pooled data showed significant differences in the operation time [SMD = -0.58 (95% CI = -0.77 to 0.40, p < 0.01)] and blood loss [SMD = -0.40, 95% CI (-0.59 to -0.21), p < 0.01] between the two groups. Compared to the anterior plate group, the Zero-P group exhibited a significantly improved JOA score and reduced NDI and VAS. However, anterior plate fusion had greater postoperative segmental and cervical Cobb's angles than the Zero-P group at the last follow-up. The fusion rate in the two groups was similar. More importantly, the Zero-P group had a lower incidence of earlier and later postoperative dysphagia.

Conclusions: Compared to anterior plate fusion, Zero-P is a safer and effective procedure, with a similar fusion rate and lower incidence of earlier and later postoperative dysphagia. However, the results of this meta-analysis should be accepted with caution due to the limitations of the study. Further evaluation and large-sample RCTs are required to confirm and update the results of this study.

No MeSH data available.


Related in: MedlinePlus