Back to Search
Start Over
A comparison study between hybrid surgery and anterior cervical discectomy and fusion for the treatment of multilevel cervical spondylosis.
- Source :
-
The bone & joint journal [Bone Joint J] 2020 Aug; Vol. 102-B (8), pp. 981-996. - Publication Year :
- 2020
-
Abstract
- Aims: Whether to perform hybrid surgery (HS) in contrast to anterior cervical discectomy and fusion (ACDF) when treating patients with multilevel cervical disc degeneration remains a controversial subject. To resolve this we have undertaken a meta-analysis comparing the outcomes from HS with ACDF in this condition.<br />Methods: Seven databases were searched for studies of HS and ACDF from inception of the study to 1 September 2019. Both random-effects and fixed-effects models were used to evaluate the overall effect of the C2-C7 range of motion (ROM), ROM of superior/inferior adjacent levels, adjacent segment degeneration (ASD), heterotopic ossification (HO), complications, neck disability index (NDI) score, visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, Odom's criteria, blood loss, and operating and hospitalization time. To obtain more credible results contour-enhanced funnel plots, Egger's and Begg's tests, meta-regression, and sensitivity analyses were performed.<br />Results: In total, 17 studies involving 861 patients were included in the analysis. HS was found to be superior to ACDF in maintaining C2-C7 ROM and ROM of superior/inferior adjacent levels, but HS did not reduce the incidence of associated level ASD. Also, HS did not cause a higher rate of HO than ACDF. The frequency of complications was similar between the two techniques. HS failed to achieve more favourable outcomes than ACDF using the NDI, VAS, JOA, and Odom's scores. HS did not show any more advantages in operating or hospitalization time but did show reduction in blood loss.<br />Conclusion: Although HS maintained cervical kinetics, it failed to reduce the incidence of ASD. This finding differs from previous reports. Moreover, patients did not show more benefits from HS with respect to symptom improvement, prevention of complications, and clinical outcomes. Cite this article: Bone Joint J 2020;102-B(8):981-996.
- Subjects :
- Adult
Aged
Databases, Factual
Disability Evaluation
Female
Humans
Intervertebral Disc Degeneration diagnostic imaging
Japan
Male
Middle Aged
Neck Pain etiology
Neck Pain physiopathology
Neck Pain surgery
Pain Measurement
Prognosis
Retrospective Studies
Severity of Illness Index
Spondylosis diagnostic imaging
Spondylosis surgery
Treatment Outcome
Cervical Vertebrae surgery
Diskectomy methods
Intervertebral Disc Degeneration surgery
Range of Motion, Articular physiology
Spinal Fusion methods
Total Disc Replacement methods
Subjects
Details
- Language :
- English
- ISSN :
- 2049-4408
- Volume :
- 102-B
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- The bone & joint journal
- Publication Type :
- Academic Journal
- Accession number :
- 32731832
- Full Text :
- https://doi.org/10.1302/0301-620X.102B8.BJJ-2019-1666.R1