Anterior approach versus posterior approach for multilevel cervical spondylotic myelopathy: a meta-analysis

doi:10.3969/j.issn.2095-4344.2014.17.024

Abstract

Abstract:

BACKGROUND: Currently, the treatment of multilevel cervical spondylotic myelopathy mainly contains anterior approach surgery and posterior approach surgery, but how to choose the incision is still controversial.
OBJECTIVE: To compare the therapeutic effect and safety of anterior and posterior approaches for the treatment of multilevel cervical spondylotic myelopathy.
METHODS: Databases such as MEDLINE, EMBASE, PubMed, Wanfang data and China National Knowledge Infrastructure were searched about related research and literature on anterior and posterior approaches for the treatment of multilevel cervical spondylotic myelopathy. Operative time, amount of blood loss, preoperative Japanese Orthopedic Association score, postoperative Japanese Orthopedic Association score, complication rate, degeneration rate of adjacent segments, cervical range of motion and reoperation rate were compared between anterior and posterior groups.
RESULTS AND CONCLUSION: 12 studies were accorded with the inclusion criteria, totally containing 790 cases (359 cases in the anterior group, and 431 cases in the posterior group). Meta-analysis showed that no significant difference in preoperative Japanese Orthopedic Association score, operative time and intraoperative amount of blood loss was detected between the anterior posterior and posterior groups (P > 0.05). Compared with the posterior group, Japanese Orthopedic Association scores were higher (P < 0.001), degeneration rate of adjacent segments was higher (P=0.02), cervical range of motion was bigger (P=0.001), complication rate was higher (P=0.000 2), and the reoperation rate was higher (P < 0.000 1) in the anterior group postoperation. Results showed that surgical invasion between anterior and posterior surgical groups in treatment of cervical myelopathy was similar, but the neurological improvement of anterior group was better, while complication rate of posterior group was lower. Therefore, the choice of surgical approach should be based on clinical practice.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: cervical vertebrae, surgical procedures, operative, treatment outcome, Meta-analysis

CLC Number:

R318

Xie Chong, Jin Ge-le, Li Zhong-wei, Wang Peng, Zhao Xue-fei, Wang Kun, Geng Chong, Chen Bo . Anterior approach versus posterior approach for multilevel cervical spondylotic myelopathy: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(17): 2762-2769.

Figures/Tables 10

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