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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

Standardized mean difference (SMD) estimate for postoperative JOA score.
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pone.0130223.g005: Standardized mean difference (SMD) estimate for postoperative JOA score.

Mentions: Five studies consisting of 320 patients reported the preoperative and postoperative JOA scores (Zero-P group, 149; Plate group, 171)[17, 18, 20, 25, 28]. The fixed-effects model was applied to compare the JOA score between the two groups. The pooled estimate revealed that the preoperative JOA score of the Zero-P group was lower and that the difference was significant between the two groups without heterogeneity (SMD = -0.24, 95% CI (−0.46 to −0.02), p = 0.03) (Fig 4). The pooled estimate of the postoperative JOA score revealed no significant difference (SMD = 0.18, 95% CI (−0.04 to 0.40), p = 0.11), with low heterogeneity: I2 = 14% (Fig 5).


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)

Standardized mean difference (SMD) estimate for postoperative JOA score.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0130223.g005: Standardized mean difference (SMD) estimate for postoperative JOA score.
Mentions: Five studies consisting of 320 patients reported the preoperative and postoperative JOA scores (Zero-P group, 149; Plate group, 171)[17, 18, 20, 25, 28]. The fixed-effects model was applied to compare the JOA score between the two groups. The pooled estimate revealed that the preoperative JOA score of the Zero-P group was lower and that the difference was significant between the two groups without heterogeneity (SMD = -0.24, 95% CI (−0.46 to −0.02), p = 0.03) (Fig 4). The pooled estimate of the postoperative JOA score revealed no significant difference (SMD = 0.18, 95% CI (−0.04 to 0.40), p = 0.11), with low heterogeneity: I2 = 14% (Fig 5).

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