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Comparison of zero-profile anchored spacer versus plate-cage construct in treatment of cervical spondylosis with regard to clinical outcomes and incidence of major complications: a meta-analysis.

Liu W, Hu L, Wang J, Liu M, Wang X - Ther Clin Risk Manag (2015)

Bottom Line: The Zero-P group had a higher subsidence rate than the PCC group (P<0.05, risk difference =0.13, 95% confidence interval [CI] 0.00-0.26).However, the Zero-P group had a significantly lower postoperative dysphagia rate than the PCC group within the first 2 weeks (P<0.05, odds ratio [OR] =0.64, 95% CI 0.45-0.91), at the 6th month [P<0.05, OR =0.20, 95% CI 0.04-0.90], and at the final follow-up time [P<0.05, OR =0.13, 95% CI 0.04-0.45].Although the Zero-P group had a higher subsidence rate than the PCC group, Zero-P had a lower postoperative dysphagia rate and might have a lower adjacent-level ossification rate.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Pu Ai Hospital, Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

ABSTRACT

Purpose: Meta-analysis was conducted to evaluate whether zero-profile anchored spacer (Zero-P) could reduce complication rates, while maintaining similar clinical outcomes compared to plate-cage construct (PCC) in the treatment of cervical spondylosis.

Methods: All prospective and retrospective comparative studies published up to May 2015 that compared the clinical outcomes of Zero-P versus PCC in the treatment of cervical spondylosis were acquired by a comprehensive search in PubMed and EMBASE. Exclusion criteria were non-English studies, noncomparative studies, hybrid surgeries, revision surgeries, and surgeries with less than a 12-month follow-up period. The main end points including Japanese Orthopedic Association (JOA) and Neck Disability Index (NDI) scores, cervical lordosis, fusion rate, subsidence, and dysphagia were analyzed. All studies were analyzed with the RevMan 5.2.0 software. Publication biases of main results were examined using Stata 12.0.

Results: A total of 12 studies were included in the meta-analysis. No statistical difference was observed with regard to preoperative or postoperative JOA and NDI scores, cervical lordosis, and fusion rate. The Zero-P group had a higher subsidence rate than the PCC group (P<0.05, risk difference =0.13, 95% confidence interval [CI] 0.00-0.26). However, the Zero-P group had a significantly lower postoperative dysphagia rate than the PCC group within the first 2 weeks (P<0.05, odds ratio [OR] =0.64, 95% CI 0.45-0.91), at the 6th month [P<0.05, OR =0.20, 95% CI 0.04-0.90], and at the final follow-up time [P<0.05, OR =0.13, 95% CI 0.04-0.45].

Conclusion: Our meta-analysis suggested that surgical treatments of single or multiple levels of cervical spondylosis using Zero-P and PCC were similar in terms of JOA score, NDI score, cervical lordosis, and fusion rate. Although the Zero-P group had a higher subsidence rate than the PCC group, Zero-P had a lower postoperative dysphagia rate and might have a lower adjacent-level ossification rate.

No MeSH data available.


Related in: MedlinePlus

Funnel plot analysis of studies on the preoperative JOA score (A), the postoperative JOA score (B), the preoperative NDI score (C), the postoperative NDI score (D), the preoperative cervical lordosis (E), the postoperative cervical lordosis (F), postoperative dysphagia rate within the first 2 weeks (G), at the 6th month (H), and at the final follow-up time (I), and the subsidence rate (J) that shows publication bias.Abbreviations: JOA, Japanese Orthopedic Association; MD, mean difference; NDI, Neck Disability Index; OR, odds ratio; SE, standard error; RD, risk difference.
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f5-tcrm-11-1437: Funnel plot analysis of studies on the preoperative JOA score (A), the postoperative JOA score (B), the preoperative NDI score (C), the postoperative NDI score (D), the preoperative cervical lordosis (E), the postoperative cervical lordosis (F), postoperative dysphagia rate within the first 2 weeks (G), at the 6th month (H), and at the final follow-up time (I), and the subsidence rate (J) that shows publication bias.Abbreviations: JOA, Japanese Orthopedic Association; MD, mean difference; NDI, Neck Disability Index; OR, odds ratio; SE, standard error; RD, risk difference.

Mentions: The Stata 12.0 software (StataCorp LP, College Station, TX, USA) was used to examine the publication bias of the main results. All funnel plots were largely symmetric including preoperative and postoperative JOA and NDI, cervical lordosis, subsidence, and postoperative dysphagia rate within the first 2 weeks (Figure 5). These results indicated that publication bias might not play a vital role in the observed effects and the conclusions were reliable.


Comparison of zero-profile anchored spacer versus plate-cage construct in treatment of cervical spondylosis with regard to clinical outcomes and incidence of major complications: a meta-analysis.

Liu W, Hu L, Wang J, Liu M, Wang X - Ther Clin Risk Manag (2015)

Funnel plot analysis of studies on the preoperative JOA score (A), the postoperative JOA score (B), the preoperative NDI score (C), the postoperative NDI score (D), the preoperative cervical lordosis (E), the postoperative cervical lordosis (F), postoperative dysphagia rate within the first 2 weeks (G), at the 6th month (H), and at the final follow-up time (I), and the subsidence rate (J) that shows publication bias.Abbreviations: JOA, Japanese Orthopedic Association; MD, mean difference; NDI, Neck Disability Index; OR, odds ratio; SE, standard error; RD, risk difference.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590636&req=5

f5-tcrm-11-1437: Funnel plot analysis of studies on the preoperative JOA score (A), the postoperative JOA score (B), the preoperative NDI score (C), the postoperative NDI score (D), the preoperative cervical lordosis (E), the postoperative cervical lordosis (F), postoperative dysphagia rate within the first 2 weeks (G), at the 6th month (H), and at the final follow-up time (I), and the subsidence rate (J) that shows publication bias.Abbreviations: JOA, Japanese Orthopedic Association; MD, mean difference; NDI, Neck Disability Index; OR, odds ratio; SE, standard error; RD, risk difference.
Mentions: The Stata 12.0 software (StataCorp LP, College Station, TX, USA) was used to examine the publication bias of the main results. All funnel plots were largely symmetric including preoperative and postoperative JOA and NDI, cervical lordosis, subsidence, and postoperative dysphagia rate within the first 2 weeks (Figure 5). These results indicated that publication bias might not play a vital role in the observed effects and the conclusions were reliable.

Bottom Line: The Zero-P group had a higher subsidence rate than the PCC group (P<0.05, risk difference =0.13, 95% confidence interval [CI] 0.00-0.26).However, the Zero-P group had a significantly lower postoperative dysphagia rate than the PCC group within the first 2 weeks (P<0.05, odds ratio [OR] =0.64, 95% CI 0.45-0.91), at the 6th month [P<0.05, OR =0.20, 95% CI 0.04-0.90], and at the final follow-up time [P<0.05, OR =0.13, 95% CI 0.04-0.45].Although the Zero-P group had a higher subsidence rate than the PCC group, Zero-P had a lower postoperative dysphagia rate and might have a lower adjacent-level ossification rate.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Pu Ai Hospital, Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

ABSTRACT

Purpose: Meta-analysis was conducted to evaluate whether zero-profile anchored spacer (Zero-P) could reduce complication rates, while maintaining similar clinical outcomes compared to plate-cage construct (PCC) in the treatment of cervical spondylosis.

Methods: All prospective and retrospective comparative studies published up to May 2015 that compared the clinical outcomes of Zero-P versus PCC in the treatment of cervical spondylosis were acquired by a comprehensive search in PubMed and EMBASE. Exclusion criteria were non-English studies, noncomparative studies, hybrid surgeries, revision surgeries, and surgeries with less than a 12-month follow-up period. The main end points including Japanese Orthopedic Association (JOA) and Neck Disability Index (NDI) scores, cervical lordosis, fusion rate, subsidence, and dysphagia were analyzed. All studies were analyzed with the RevMan 5.2.0 software. Publication biases of main results were examined using Stata 12.0.

Results: A total of 12 studies were included in the meta-analysis. No statistical difference was observed with regard to preoperative or postoperative JOA and NDI scores, cervical lordosis, and fusion rate. The Zero-P group had a higher subsidence rate than the PCC group (P<0.05, risk difference =0.13, 95% confidence interval [CI] 0.00-0.26). However, the Zero-P group had a significantly lower postoperative dysphagia rate than the PCC group within the first 2 weeks (P<0.05, odds ratio [OR] =0.64, 95% CI 0.45-0.91), at the 6th month [P<0.05, OR =0.20, 95% CI 0.04-0.90], and at the final follow-up time [P<0.05, OR =0.13, 95% CI 0.04-0.45].

Conclusion: Our meta-analysis suggested that surgical treatments of single or multiple levels of cervical spondylosis using Zero-P and PCC were similar in terms of JOA score, NDI score, cervical lordosis, and fusion rate. Although the Zero-P group had a higher subsidence rate than the PCC group, Zero-P had a lower postoperative dysphagia rate and might have a lower adjacent-level ossification rate.

No MeSH data available.


Related in: MedlinePlus