Background In this study, we systematically analyze the differences in complications between anterior cervical diskectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) in two- and three-level cervical spondylotic myelopathy (CSM). Methods We performed a systematic search in MEDLINE, EMBASE, PubMed, Web of Science, Cochrane databases, Chinese Biomedical Literature Database, CNKI, and Wan Fang Data for all relevant studies. All statistical analyses were performed using Review Manager version 5.3. Results A total of 11 articles with 849 study subjects were included, with 474 patients in the ACDF group and 375 patients in the ACCF group. The results of the meta-analysis showed that in C5 palsy (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.16–1.06), pseudarthrosis (OR: 1.07; 95% CI: 0.23–5.07), dysphagia (OR: 1.06; 95% CI: 0.60–1.86), infection (OR: 0.41; 95% CI: 0.16–1.09), cerebrospinal fluid leakage (OR: 1.21; 95% CI: 0.39–3.73), graft dislodgment (OR: 0.28; 95% CI: 0.06–1.37), and hematoma (OR: 0.32; 95% CI: 0.06–1.83), there are no significant differences between the ACDF and ACCF groups, whereas total complication (OR: 0.50; 95% CI: 0.31–0.80) showed that the ACDF group had a significantly lower morbidity than the ACCF group. Furthermore, the three-level subgroup of ACDF had significantly better results in C5 palsy (OR: 0.31; 95% CI: 0.11–0.88), infection (OR: 0.22; 95% CI: 0.05–0.94), graft dislodgment (OR: 0.07; 95% CI: 0.01–0.40), and total complication (OR: 0.37; 95% CI: 0.23–0.60) compared with the ACCF subgroup. Conclusion In general, postoperative pseudarthrosis, dysphagia, cerebrospinal fluid leakage, hematoma, C5 palsy, infection, and graft dislodgment did not differ significantly between the two groups. Total complication was significantly less in the ACDF group compared to the ACCF group. In the three-level subgroup, the morbidity of C5 palsy, infection, and graft dislodgment was significantly lower in ACDF than in ACCF.

Purpose: To evaluate the clinical efficacy and safety of full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) for treatment of single-level lumbar degenerative spondylolisthesis. Methods: Fifty-three patients were divided into 2 groups according to the surgical techniques: Endo-TLIF (n = 25) and TLIF (n = 28). Clinical efficacy was evaluated by pre- and post-operative. The operation time, operative blood loss, postoperative increased amount of serum creatine phosphohykinase (CPK), postoperative drainage volume, postoperative hospital stay time, total cost and operative complications were also recorded. Results: Compared with TLIF group, Endo-TLIF group had similar intraoperative blood loss, less postoperative increased CPK, less postoperative drainage volume and shorter postoperative hospital stay but longer operative time and more total cost. The postoperative VAS back, leg scores and ODI scores were significantly improved compared with the preoperative scores in both two groups, and more significant improvement of postoperative VAS back scores and ODI scores were showed in Endo-TLIF group at one-month follow-up period (P < 0.05, respectively). No difference was found in intervertebral fusion rate between the two groups. Conclusion: Endo-TLIF indicates similar clinical effect compared with TLIF for the treatment of lumbar degenerative spondylolisthesis. And it has many surgical advantages such as less muscle trauma, less postoperative back pain, and fast functional recovery of the patient. However, steep learning curve, longer operative time and more total cost may be the disadvantages that limit this technique. And the Endo-TLIF treatment of patients with bilateral lateral recess stenosis is considered as a relative contraindication.