Meta-Analysis of Treatment for Adjacent Two-Segment Cervical Spondylotic Myelopathy: A Comparison Between Anterior Cervical Corpectomy and Fusion and Anterior Cervical Discectomy and Fusion.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY Global Spine Journal Pub Date : 2024-10-30 DOI:10.1177/21925682241297586

Lei Chen, Zhongyi Zhang, Ju Li, Peijian Tong, Taotao Xu

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Abstract

Study design: A systematic review and meta-analysis comparing the outcomes of Anterior Cervical Discectomy and Fusion (ACDF) vs Anterior Cervical Corpectomy and Fusion (ACCF) in treating adjacent two-segment cervical spondylotic myelopathy.

Objective: To assess the clinical effectiveness and safety of ACDF compared to ACCF.

Methods: A literature search was conducted in Cochrane Library, Web of Science, PubMed, and Embase up to December 2023. Studies included were prospective and observational involving ACDF or ACCF for adjacent two-segment cervical spondylotic myelopathy. Data were analyzed using RevMan 5.4 software.

Results: Ten studies (nine case-control and one RCT) were included. ACDF showed a shorter hospital stay (SMD = -0.29, 95% CI: -0.53 to -0.04, P < 0.05), better Cobb angle (SMD = 0.52, 95% CI: 0.31 to 0.74, P < 0.01), and improved T1S (SMD = 0.54, 95% CI: 0.28 to 0.80, P < 0.01). No significant differences were found in upper limb VAS, neck VAS, JOA scores, NDI, fusion rates, C2-7 SVA, total complications, blood loss, and operation time.

Conclusions: ACDF and ACCF are both effective for adjacent two-segment cervical spondylotic myelopathy, with ACDF offering advantages in hospitalization duration and cervical curvature restoration, making it the preferred surgical approach. Further research is needed to validate these findings.

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相邻两节段颈椎脊髓病治疗方法的 Meta 分析：颈椎前路椎间盘切除融合术与颈椎前路椎间盘切除融合术的比较。

研究设计：一项系统综述和荟萃分析，比较颈椎前路椎间盘切除融合术（ACDF）与颈椎前路椎体后凸切除融合术（ACCF）治疗邻近两节段颈椎病的疗效：评估 ACDF 与 ACCF 相比的临床有效性和安全性：方法：在 Cochrane Library、Web of Science、PubMed 和 Embase 中进行文献检索，检索时间截至 2023 年 12 月。纳入的研究均为前瞻性和观察性研究，涉及邻近两节段颈椎脊髓病的 ACDF 或 ACCF。数据使用RevMan 5.4软件进行分析：结果：共纳入10项研究（9项病例对照研究和1项RCT研究）。ACDF显示住院时间更短（SMD = -0.29，95% CI：-0.53至-0.04，P <0.05），Cobb角更好（SMD = 0.52，95% CI：0.31至0.74，P <0.01），T1S得到改善（SMD = 0.54，95% CI：0.28至0.80，P <0.01）。上肢VAS、颈部VAS、JOA评分、NDI、融合率、C2-7 SVA、总并发症、失血量和手术时间均无明显差异：ACDF和ACCF对相邻两节段颈椎病均有效，其中ACDF在住院时间和颈椎曲度恢复方面更具优势，因此是首选的手术方法。要验证这些发现，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Global Spine Journal Medicine-Surgery

CiteScore

6.20

自引率

8.30%

发文量

278

审稿时长

8 weeks

期刊介绍： Global Spine Journal (GSJ) is the official scientific publication of AOSpine. A peer-reviewed, open access journal, devoted to the study and treatment of spinal disorders, including diagnosis, operative and non-operative treatment options, surgical techniques, and emerging research and clinical developments.GSJ is indexed in PubMedCentral, SCOPUS, and Emerging Sources Citation Index (ESCI).