Comparison of zero-profile anchored spacer versus plate-cage construct in treatment of XXXX with regard to clinical outcomes and incidence of major complications: a meta-analysis.

@entity717 @entity1515 @entity4720 @entity1282
PURPOSE: Meta-analysis was conducted to evaluate whether zero-profile anchored spacer (Zero-P) could reduce complication rates, while maintaining similar clinical outcomes compared to plate-cage construct (PCC) in the treatment of @entity4720 . METHODS: All prospective and retrospective comparative studies published up to May 2015 that compared the clinical outcomes of Zero-P versus PCC in the treatment of @entity4720 were acquired by a comprehensive search in PubMed and EMBASE. Exclusion criteria were non-English studies, noncomparative studies, hybrid surgeries, revision surgeries, and surgeries with less than a 12-month follow-up period. The main end points including Japanese Orthopedic Association (JOA) and @entity717 ( @entity717 ) scores, cervical @entity1515 , fusion rate, subsidence, and @entity1282 were analyzed. All studies were analyzed with the RevMan 5.2.0 software. Publication biases of main results were examined using Stata 12.0. RESULTS: A total of 12 studies were included in the meta-analysis. No statistical difference was observed with regard to preoperative or postoperative JOA and @entity717 scores, cervical @entity1515 , and fusion rate. The Zero-P group had a higher subsidence rate than the PCC group (P<0.05, risk difference =0.13, 95% confidence interval [CI] 0.00-0.26). However, the Zero-P group had a significantly lower postoperative @entity1282 rate than the PCC group within the first 2 weeks (P<0.05, odds ratio [OR] =0.64, 95% CI 0.45-0.91), at the 6th month [P<0.05, OR =0.20, 95% CI 0.04-0.90], and at the final follow-up time [P<0.05, OR =0.13, 95% CI 0.04-0.45]. CONCLUSION: Our meta-analysis suggested that surgical treatments of single or multiple levels of @entity4720 using Zero-P and PCC were similar in terms of JOA score, @entity717 score, cervical @entity1515 , and fusion rate. Although the Zero-P group had a higher subsidence rate than the PCC group, Zero-P had a lower postoperative @entity1282 rate and might have a lower adjacent-level ossification rate.
