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Review
. 2015 Feb 13:16:29.
doi: 10.1186/s12891-015-0490-9.

Anterior cervical discectomy and fusion may be more effective than anterior cervical corpectomy and fusion for the treatment of cervical spondylotic myelopathy

Li Guan  1 , Yong Hai  2 , Jin-Cai Yang  3 , Li-Jin Zhou  4 , Xiao-Long Chen  5
Affiliations
Review

Anterior cervical discectomy and fusion may be more effective than anterior cervical corpectomy and fusion for the treatment of cervical spondylotic myelopathy

Li Guan et al. BMC Musculoskelet Disord. .

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: Our findings provide empirical evidence that ACDF may be more effective than ACCF for CSM treatment.

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Figures

Figure 1
Figure 1
The methodological quality of 13 included studies based on the revised Jadad score system.
Figure 2
Figure 2
Forest plots for the relationships based on hospital time, operation time, operative blood loss, fusion rate, preoperative JOA score and postoperative JOA score for the relationships of anterior cervical corpectomy and fusion with anterior cervical discectomy and fusion in patients with cervical spondylotic myelopathy.
Figure 3
Figure 3
Sensitivity analysis of the summary odds ratio coefficients for the relationships of anterior cervical corpectomy and fusion with anterior cervical discectomy and fusion in patients with cervical spondylotic myelopathy.
Figure 4
Figure 4
Funnel plot of publication biases for the relationships of anterior cervical corpectomy and fusion with anterior cervical discectomy and fusion in patients with cervical spondylotic myelopathy.
See this image and copyright information in PMC

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