Comparison of two anterior fusion methods in two-level XXXX : a meta-analysis.

@entity1 @entity7126 @entity548 @entity1515 @entity158 @entity4720
OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of anterior cervical corpectomy and fusion (ACCF) and anterior cervical discectomy and fusion (ACDF) for treating two-adjacent-level @entity4720 ( @entity4720 ). DESIGN: A meta-analysis of the two anterior fusion methods was conducted. The electronic databases of PubMed, the Cochrane Central Register of Controlled Trials, ScienceDirect, CNKI, WANFANG DATA and CQVIP were searched. Quality assessment of the included studies was evaluated using the Cochrane Risk of Bias Tool and the Methodological Index for Non-Randomised Studies criteria. Pooled risk ratios of dichotomous outcomes and standardised mean differences (SMDs) of continuous outcomes were generated. Using the   (2) and I(2) tests, the statistical heterogeneity was assessed. Subgroup and sensitivity analyses were also performed. @entity1 : Nine eligible trials with a total of 631 @entity1 and a male-to-female ratio of 1.38:1 were included in this meta-analysis. INCLUSION CRITERIA: Randomised controlled trials (RCTs) and non-randomised controlled trials that adopted ACCF and ACDF to treat two-adjacent-level @entity4720 were included. RESULTS: No significant differences were identified between the two groups regarding hospital stay, the Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) scores for neck and arm @entity158 (ROM), fusion ROM, fusion rate, adjacent-level ossification and complications, while ACDF had significantly less @entity548 ( @entity7126 =1.14, 95% CI (0.74 to 1.53)); a shorter operation time ( @entity7126 =1.13, 95% CI (0.82 to 1.45)); greater cervical @entity1515 , total cervical ( @entity7126 =-2.95, 95% CI (-4.79 to -1.12)) and fused segment ( @entity7126 =-2.24, 95% CI (-3.31 to -1.17)); higher segmental height ( @entity7126 =-0.68, 95% CI (-1.03 to -0.34)) and less graft subsidence ( @entity7126 =0.40, 95% CI (0.06 to 0.75)) compared to ACCF. CONCLUSIONS: The results suggested that ACDF has more advantages compared to ACCF. However, additional high-quality RCTs and a longer follow-up duration are needed.
