• Medicine · Aug 2018

    Review Meta Analysis

    Anterior cervical discectomy and fusion versus hybrid surgery in multilevel cervical spondylotic myelopathy: A meta-analysis.

    • Chun-Ming Zhao, Qian Chen, Yu Zhang, Ai-Bing Huang, Wen-Yuan Ding, and Wei Zhang.
    • Department of Orthopaedic Surgery, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou, Jiangsu Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
    • Medicine (Baltimore). 2018 Aug 1; 97 (34): e11973.

    ObjectiveA meta-analysis was performed to compare the radiographic and surgical outcomes between anterior cervical discectomy and fusion (ACDF) and hybrid surgery (HS, corpectomy combined with discectomy) in the treatment for multilevel cervical spondylotic myelopathy (mCSM).Summary Of Background DataBoth ACDF and HS are used to treat mCSM, however, which one is better treatment for mCSM remains considerable controversy.MethodsAn extensive search of literature was searched in PubMed/Medline, Embase, the Cochrane library, CNKI, and WANFANG databases on ACDF versus HS treating mCSM from January 2011 to December 2017. The following variables were extracted: blood loss, operation time, fusion rate, Cobb angles of C2-C7, total complications, dysphagia, hoarseness, C5 palsy, infection, cerebral fluid leakage, epidural hematoma, and graft subsidence. Data analysis was conducted with RevMan 5.3 and STATA 12.0.ResultsA total of 4 studies including 669 patients were included in our study. The pooled analysis showed that there were no significant difference in the operation time, fusion rate, Cobb angles of C2-C7, dysphagia, hoarseness, C5 palsy, infection, cerebral fluid leakage, epidural hematoma, and graft subsidence. However, there were significant difference between 2 groups in blood loss [P < .00001, SMD = -30.29 (-45.06, -15.52); heterogeneity: P = .38, I = 0%= and total complications [P = .04, OR = 0.66 95%CI (0.44, 0.98); heterogeneity: P = .37, I = 4%].ConclusionsBased on our meta-analysis, except for blood loss and total complications, both ACDF and hybrid surgery are effective options for the treatment of multilevel cervical spondylotic myelopathy.

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