The authors declare that they have no competing interests.
Li Guan designed the study, conceived and supervised the study, performed the examination and the analysis and drafted the paper. Yong Hai conceived and supervised the study, performed the statistical analysis and interpreted the results. Jin-Cai Yang performed the examination and the analysis, performed the statistical analysis and interpreted the results. Li-Jin Zhou performed the statistical analysis and revised the paper. and Xiao-Long Chen drafted the paper and revised the paper. All authors read and approved the final paper.
This meta-analysis explored the efficacy and safety of anterior cervical corpectomy and fusion (ACCF) comparing to anterior cervical discectomy and fusion (ACDF) in treating cervical spondylotic myelopathy (CSM) patients.
Several electronic databases were searched combined with manually searching. Thirteen randomized controlled studies were enrolled with 1,062 CSM patients, including 468 patients and 594 patients in the in the ACCF and ACDF group, respectively. The meta-analysis was then performed using the STATA 12.0 software. Crude standard mean difference (SMD) or odds ratio (OR) with their 95% confidence intervals (CI) were calculated.
Our meta-analysis results revealed that CSM patients in ACDF group showed less blood loss than those in ACCF group (SMD = 1.21, 95% CI = 1.03 ~ 1.39, P < 0.001). The operation time of CSM patients in the ACDF group was also obviously shorter than those in ACCF group (SMD = 0.40, 95% CI = 0.23 ~ 0.57, P < 0.001). Furthermore, CSM patients in ACDF group had shorter hospital time than those in ACCF group (SMD = 0.45, 95% CI = 0.21 ~ 0.69, P < 0.001).
Our findings provide empirical evidence that ACDF may be more effective than ACCF for CSM treatment.
Fang M, Lu J, Wei Y, Yu W, Wang X, Ouyang J. Early outcome of using Zero-profile implant system in treatment of cervical spondylosis. Chin J Reparative Reconstructive Surg. 2013;27:1206–9.
Arvin B, Kalsi-Ryan S, Mercier D, Furlan JC, Massicotte EM, Fehlings MG. Preoperative magnetic resonance imaging is associated with baseline neurological status and can predict postoperative recovery in patients with cervical spondylotic myelopathy. Spine (Phila Pa 1976). 2013;38:1170–6. CrossRef
Nanda A, Sharma M, Sonig A, Ambekar S, Bollam P: Surgical complications of Anterior Cervical Discectomy and Fusion for cervical degenerative disc disease: A Single Surgeon Experience of 1576 patients. World Neurosurg 2013.
Fang Z, Tian R, Sun TW, Yadav SK, Hu W, Xie SQ: Expansion Open-door Laminoplasty with Foraminotomy versus Anterior Cervical Discectomy and Fusion for Coexisting Multilevel Cervical Myelopathy and Unilateral Radiculopathy. J Spinal Disord Tech 2013.
Burkhardt JK, Mannion AF, Marbacher S, Dolp PA, Fekete TF, Jeszenszky D, et al. A comparative effectiveness study of patient-rated and radiographic outcome after 2 types of decompression with fusion for spondylotic myelopathy: anterior cervical discectomy versus corpectomy. Neurosurg Focus. 2013;35:E4. CrossRefPubMed
Hessler C, Boysen K, Westphal M, Regelsberger J. Functional and radiological outcome after ACDF in 67 cases. Z Orthop Unfall. 2011;149:683–7. PubMed
Oh MC, Zhang HY, Park JY, Kim KS. Two-level anterior cervical discectomy versus one-level corpectomy in cervical spondylotic myelopathy. Spine (Phila Pa 1976. 2009;34:692–6. CrossRef
Huang SH, Liu ZL, Luo Y, Deng ZY, Shu Y, Han ZM, et al. The comparison of two anterior procedure for treating cervical spondylotic myelopathy. Practical Clinical Medicine. 2007;8:49–52.
Jia XL, Tan ZJ, Yang FB, Yang M, Wan G. Comparison between single-level cervical corpetomy and two-level discectomy in two-adjacent-level cervical spondylotic myelopathy. Orthopedic Journal of China. 2012;20:1931–4.
Liu Y, Hou Y, Yang L, Chen H, Wang X, Wu X, et al. Comparison of 3 reconstructive techniques in the surgical management of multilevel cervical spondylotic myelopathy. Spine (Phila Pa 1976). 2012;37:E1450–1458. CrossRef
Qi M, Wang XW, Liu Y, Liang L, Chen HJ, Yang LL, et al. Comparative analysis of complications of different anterior decompression produres for treating multievel cervical spondylotic myelopathy. Chinese Journal of Spine and Spinal Cord. 2012;22:963–8.
Sun ZF, He B, Jiang JX. The comparison of therapeutic effecacy between two operative methods for the treatment of CSM. Chinese Journal of Bone Joint Injury. 2013;28:240–1.
Yu YL, Gong WC, Xin B, Yuan F, Li Q. The comparison of therapeutic effecacy between two operative methods for the treatment of twe-adjacent-level CSM. Journal of Qiqihar Medical College. 2007;28:2821–3.
Zhang SM, Zhang ZJ, Liu YZ, Zhang LT, Li X, Zhou W, et al. Case–control study of two methods in treating two-level cervical spondylitic myelopathy. Chinese Journal of Bone Joint Injury. 2013;28:604–6.
Zhang W, Chen DY, Yang LL, Chen Y, Tian HJ, Miu JH, et al. Clinical results of anterior cervial discectomy or corpectomy in 2-level cervical spondylotic myelopathy. Orthopedic Journal of China. 2011;19:181–3.
Konya D, Ozgen S, Gercek A, Pamir MN. Outcomes for combined anterior and posterior surgical approaches for patients with multisegmental cervical spondylotic myelopathy. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 2009;16(3):404–9. CrossRef
- Anterior cervical discectomy and fusion may be more effective than anterior cervical corpectomy and fusion for the treatment of cervical spondylotic myelopathy
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
Mail Icon II