Anterior cervical discectomy versus corpectomy for multilevel cervical spondylotic myelopathy: a meta-analysis

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• 作者：Shan-Wen Xiao ; Hua Jiang ; Li-Jing Yang ; Zeng-Ming Xiao
• 关键词：Anterior decompression ; Cervical spondylotic myelopathy ; Discectomy ; Corpectomy ; Meta ; analysis
• 刊名：European Spine Journal
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：24
• 期：1
• 页码：31-39
• 全文大小：1,579 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgical Orthopedics
  Neurosurgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0932

文摘

Purpose This is a meta-analysis to compare the results between anterior cervical discectomy fusion (ACDF) and anterior cervical corpectomy fusion (ACCF) for the patients with multilevel cervical spondylotic myelopathy (MCSM). Methods Systematic review and meta-analysis of cohort studies between ACDF with plate fixation and ACCF with plate fixation for the treatment of MCSM. An extensive search of literature was performed in PubMed, Mediline, Embase and the Cochrane library. The following outcome measures were extracted: JOA scores, fusion rate, cervical lordosis (C2-), complications, blood loss and operation time. Data analysis was conducted with RevMan 5.0. Results Four cohorts (six studies) involving 258 patients were included in this study. The pooled analysis showed that there was no significant difference in the postoperative JOA score [WMD?=??.14 (?.37, 1.10), P?=?0.83], fusion rate [OR?=?0.84 (0.15, 4.86), P?=?0.85] between two group. However, there was significant difference in the cervical lordosis [WMD?=?3.38 (2.52, 4.23), P?P?=?0.01, 0.005 respectively), blood loss [WMD?=??2.53 (?3.53, ?1.52), P?P? Conclusions As compared with ACCF with plate fixation, ACDF with plate fixation showed no significant differences in terms of postoperative JOA score, fusion rate, but better improved cervical lordosis, lower complication and smaller surgical trauma. As the limitations of small sample and short follow-up in this study, it still could not be identified whether ACDF with plate fixation is more effective and safer than ACCF with plate fixation.