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

BMC Musculoskelet Disord. 2015 Feb 13:16:29. doi: 10.1186/s12891-015-0490-9.

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.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Biomechanical Phenomena
  • Blood Loss, Surgical / prevention & control
  • Cervical Vertebrae / physiopathology
  • Cervical Vertebrae / surgery*
  • Diskectomy* / adverse effects
  • Humans
  • Intervertebral Disc / physiopathology
  • Intervertebral Disc / surgery*
  • Length of Stay
  • Odds Ratio
  • Operative Time
  • Postoperative Complications / etiology
  • Recovery of Function
  • Risk Factors
  • Spinal Cord Diseases / diagnosis
  • Spinal Cord Diseases / physiopathology
  • Spinal Cord Diseases / surgery*
  • Spinal Fusion* / adverse effects
  • Spondylosis / diagnosis
  • Spondylosis / physiopathology
  • Spondylosis / surgery*
  • Time Factors
  • Treatment Outcome