Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (17): 3134-3138.doi: 10.3969/j.issn.1673-8225.2012.17.022

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Two anterior decompression and fusion treatments for two-level cervical spondylotic myelopathy: A Meta analysis 

Zhang Wei, Liao Wen-sheng, Wang Li-min, Bao Heng   

  1. Department of Orthopedics, First Affiliated Hospital of Zhengzhou University, Zhengzhou  450052, Henan Province, China
  • Received:2011-12-26 Revised:2012-02-06 Online:2012-04-22 Published:2012-04-22
  • Contact: Liao Wen-sheng, Associate professor, Master’s supervisor, Department of Orthopedics, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China hnzzlws@hotmail.com
  • About author:Zhang Wei★, Studying for master’s degree, Department of Orthopedics, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China zwaf@163.com

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Abstract:

BACKGROUND: There are two main ways for cervical spondylotic myelopathy (CSM) in anterior approaches, one is anterior cervical discectomy with fusion (ACDF) and the other is anterior cervical corpectomy with fusion (ACCF). The optimal surgical strategy remains controversial for two-level CSM.
OBJECTIVE: To compare the clinical effects between ACDF and ACCF in treating two-level CSM.
METHODS: A computer-based online search of Cochrane Library (issue 4, 2011), PubMed database (1966/2011-11), EMBASE database (1974/2011-11), CBM database (1978/2011-11), CNKI database (1994/2011-11) and Wanfang database (1997/2010-11) was preformed for literatures in English and Chinese. All controlled studies of ACDF and ACCF for the treatment of two-level CSM were identified. Two reviewers assessed the trials and extracted data independently. Meta analysis was conducted with the Revman 5.1 software provided by Cochrane collaboration.
RESULTS AND CONCLUSION: A total of 382 cases in 5 controlled trials were included. Totally 201 patients were in the ACDF group and 181 patients were in the ACCF group. The results of Meta analysis showed that there were statistically significant differences in operation time, bleeding amount and cervical lordosis between ACDF group and ACCF group (P < 0.05), but there was no significant difference in the function recovery rate of spinal cord, fusion rate and complications between two groups (P > 0.05). Compared with ACCF, ACDF had the advantages of a shorter operation time, less bleeding and better cervical lordosis for two-level CSM. But there was no obvious difference in the function recovery rate of spinal cord, fusion rate and complications.
 

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