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Review
. 2015 Dec 27:21:4057-67.
doi: 10.12659/msm.896584.

Comparison of Hybrid Surgery Incorporating Anterior Cervical Discectomy and Fusion and Artificial Arthroplasty versus Multilevel Fusion for Multilevel Cervical Spondylosis: A Meta-Analysis

Leyuan Zang  1 , Min Ma  1 , Jianxin Hu  1 , Hao Qiu  1 , Bo Huang  1 , Tongwei Chu  1
Affiliations
Review

Comparison of Hybrid Surgery Incorporating Anterior Cervical Discectomy and Fusion and Artificial Arthroplasty versus Multilevel Fusion for Multilevel Cervical Spondylosis: A Meta-Analysis

Leyuan Zang et al. Med Sci Monit. .

Abstract

BACKGROUND Few studies have reported the safety and efficacy of hybrid surgery (HS), and some of the studies comparing HS with ACDF have reported conflicting results. We conducted this meta-analysis to clarify the advantages of HS in the treatment of multilevel cervical spondylosis. MATERIAL AND METHODS We performed a systematic literature search in PubMed, Medline, and CNKI to identify relevant controlled trials published up to October 2015. The standardized mean difference (SMD) and 95% confidence interval (95% CI) of the perioperative parameters, visual analogue scale pain score (VAS), neck disability index (NDI), and range of motion (ROM) of C2-C7 and adjacent segments were calculated. We also analyzed complications and Odom scale scores using risk difference (RD) and 95% CI. RESULTS In total, 7 studies were included. The pooled data exhibited significant differences in blood loss between the 2 groups. However, there was no evidence indicating significant differences in operation time, complications, VAS, NDI, or Odom scale scores. Compared with the ACDF group, the HS group exhibited significantly protected C2-C7 ROM and reduced adjacent-segment ROM. CONCLUSIONS The safety of HS may be as good as that of ACDF. Furthermore, HS is superior to ACDF in conserving cervical spine ROM and decreasing adjacent-segment ROM. However, the results should be accepted cautiously due to the limitations of the study. Studies with larger sample sizes and longer follow-up periods are required to confirm and update the results of the present study.

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Figures

Figure 1
Figure 1
Flow diagram of literature screening.
Figure 2
Figure 2
Summary of bias risk of randomized controlled trials.
Figure 3
Figure 3
Forest plot for comparison of complications between HS group and ACDF group.
Figure 4
Figure 4
Forest plot for comparison of C2–C7 ROM between HS group and ACDF group.
Figure 5
Figure 5
Forest plot for comparison of superior adjacent-segment ROM between HS group and ACDF group.
Figure 6
Figure 6
Forest plot for comparison of inferior adjacent-segment ROM between HS group and ACDF group.
Figure 7
Figure 7
Forest plot for comparison of “good” rate between HS group and ACDF group.
Figure 8
Figure 8
Plot of sensitivity analysis of operation time between HS group and ACDF group.
Figure 9
Figure 9
Plot of sensitivity analysis of blood loss between HS group and ACDF group.
Figure 10
Figure 10
Funnel plot for publication bias of operation time.
Figure 11
Figure 11
Funnel plot for publication bias of blood loss.
See this image and copyright information in PMC

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References

    1. Bohlman HH, Emery SE, Goodfellow DB, Jones PK. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients. J Bone Joint Surg Am. 1993;75(9):1298–307. - PubMed
    1. Bose B. Anterior cervical fusion using Caspar plating: analysis of results and review of the literature. Surg Neurol. 1998;49(1):25–31. - PubMed
    1. Hilibrand AS, Carlson GD, Palumbo MA, Bohlman HH. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1998;81(4):519–28. - PubMed
    1. Pimenta L, McAfee PC, Cappuccino A, et al. Superiority of multilevel cervical arthroplasty outcomes versus single-level outcomes: 229 consecutive PCM prostheses. Spine (Phila Pa 1976) 2007;32(12):1337–44. - PubMed
    1. Phillips FM, Tzermiadianos MN, Voronov LI, et al. Effect of two-level total disc replacement on cervical spine kinematics. Spine(Phila Pa 1976) 2009;34( 22):E794–99. - PubMed