Anterior cervical discectomy versus corpectomy for multilevel cervical spondylotic myelopathy: a meta-analysis

Xiao, Shan-Wen; Jiang, Hua; Yang, Leixiang; Xiao, Zengming

doi:10.1007/s00586-014-3607-1

Cited by 58 publications

(49 citation statements)

References 45 publications

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“…a Sagittal CT scan and b lateral radiograph of two-level titanium (radiopaque) cage and anterior plate reconstruction following C7-T1 corpectomy. c Sagittal CT scan and d lateral radiograph of two-level PEEK (radiolucent) cage and anterior plate reconstruction following C5-6 vertebrectomy scans in all of the studies would have yielded lower fusion rates, the results are not substantially different than prior reported literature for structural bone grafts and fixed cages [16,24,43,47].…”

Section: Fusionmentioning

confidence: 83%

A systematic review of the use of expandable cages in the cervical spine

Elder

Kosztowski

et al. 2015

Neurosurg Rev

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Expandable vertebral body replacement cages (VBRs) have been widely used for reconstruction of the thoracolumbar spine following corpectomy. However, their use in the cervical spine is less common, and currently, no expandable cages on the market are cleared or approved by the US Food and Drug Administration for use in the cervical spine. The objective of this study was to perform a systematic review on the use of expandable cages in the treatment of cervical spine pathology with a focus on fusion rates, deformity correction, complications, and indications. A comprehensive Medline search was performed, and 24 applicable articles were identified and included in this review. The advantages of expandable cages include greater ease of implantation with less risk of damage to the end plate, less intraoperative manipulation of the device, and potentially greater control over lordosis. They may be particularly advantageous in cases with poor bone quality, such as patients with osteoporosis or metastatic tumors that have been radiated. However, there is a potential risk of overdistraction, which is increased in the cervical spine, their minimum height limits their use in cases with collapsed vertebra, and the amount of hardware in the expansion mechanism may limit the surface area available for fusion. The use of expandable VBRs are a valuable tool in the armamentarium for reconstruction of the anterior column of the cervical spine with an acceptable safety profile. Although expandable cervical cages are clearly beneficial in certain clinical situations, widespread use following all corpectomies is not justified due to their significantly greater cost compared to structural bone grafts or non-expandable VBRs, which can be utilized to achieve similar clinical outcomes.

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Section: Fusionmentioning

confidence: 83%

A systematic review of the use of expandable cages in the cervical spine

Elder

Kosztowski

et al. 2015

Neurosurg Rev

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“…The self-assessment NDI scores were obtained from each patient. The neck disability index (NDI) scores were evaluated by categorizing them into the following standard intervals: no disability (0-4), mild (5)(6)(7)(8)(9)(10)(11)(12)(13)(14), moderate (15-24), severe (25-34), and complete disability (> 34). The clinical prognosis was assessed by the NDI scores, which were collected in preoperation and at least 1 year after surgery.…”

Section: Methodsmentioning

confidence: 99%

“…Anterior cervical hybrid decompression and fusion (ACHDF) can decompress the anterior cord, reduce the amount of surgical bleeding and maintain the stability of the spinal column [1,2]. Studies have revealed that 3-level anterior cervical discectomy and fusion (ACDF) is associated with a higher incidence of nonunion due to increased graft-host interfaces [3], whereas 2-level ACDF has a higher rate of device-related complications [4,5]. Therefore, combining anterior cervical corpectomy and fusion (ACCF) and ACDF has been introduced as an alternative procedure because it may avoid some drawbacks of traditional fusion techniques [6].…”

Section: Introductionmentioning

confidence: 99%

Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy

Huang

Lan

2019

BMC Musculoskelet Disord

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BackgroundTo investigate the relationships between sagittal parameters and health-related quality of life (HRQOL) scores following anterior cervical hybrid decompression and fusion (ACHDF) of multilevel cervical spondylotic myelopathy (CSM) and to study the impact of the T1 slope (T1 s).MethodsIn total, 42 patients with complete radiographic measurements following ACHDF in the Spine Surgery Department of the First Affiliated Hospital of Fujian Medical University from August 2014 to January 2017 were retrospectively analysed. Radiographic measurements included C2–7 lordosis, T1 s, C2–7 sagittal vertical axis (SVA), cervical tilting and cranial tilting. The neck disability index (NDI) was used to evaluate the HRQOL. Spearman’s correlation coefficients were calculated between pairs of cervical sagittal parameters and NDI scores.ResultsPreoperative NDI scores were correlated with preoperative T1 s (r = 0.413); follow-up NDI scores were correlated with follow-up T1 s (r = 0.534). The regression analysis indicated that a preoperative T1 s value of 42.36° corresponded to a preoperative NDI score of 25 (r2 = 0.171, P < 0.001). A follow-up T1 s value of 48.61° corresponded to a follow-up NDI score of 25 (r2 = 0.421, P < 0.01). The differences in C2–7 SVA and cranial tilting before and after the operation were statistically significant (P < 0.05).ConclusionThis study showed that the sagittal balance of the cervical vertebrae changed significantly after ACHDF, showing a forward trend. The sagittal parameters after ACHDF were related to clinical prognosis. An excessive T1 s can be considered a risk factor. The T1 s could provide a reference value to determine the correction of the sagittal balance of the cervical spine.

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“…Random-effects models were used depended on the heterogeneity of the studies included. Heterogeneity was analyzed with both the Chi squared test I square test, where p value <0.10 for the Chi squared and I 2 ≥50% implied heterogeneity [16]. The forest plot was a graphic presentation of the analytic result.…”

Section: Methodsmentioning

confidence: 99%

Risk Factors for Complications after Reduction Mammoplasty: A Meta-Analysis

et al. 2016

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BackgroundReduction mammoplasty (RM) is a proven method of treating macromastia, but the risk factors for postoperative complications have not been clearly identified. Through this meta-analysis, the authors aimed to identify the risk factors of RM complications.MethodsAn extensive search of the literature describing complications after RM was performed using the PubMed Central, Embase, and Cochrane databases. The following risk factors were extracted: age, body mass index (BMI), tissue resection weight per breast (TRW), smoking and radiation therapy. Odds ratios (OR) were pooled with 95% confidence intervals (CI) to evaluate the relationship between these risk factors and complications after RM.ResultsA total of 16 unique studies including 10 593 patients were included in the final analysis. It showed that there was a significant difference in complications in BMI ≥30 kg/m2 (OR 0.73; 95% CI: 0.61–0.89, p = 0.001) and smoking (OR 1.56; 95% CI: 0.98–2.49, p = 0.06). Infection in those with BMI ≥30 kg/m2 showed a significant difference (OR 0.68; 95% CI: 0.52–0.89, p = 0.004), as well as wound dehiscence in smokers (OR 2.73; 95% CI: 1.60–4.67, p = 0.0002) and infection in irradiated breasts (OR 20.38; 95% CI: 3.42–121.35, p = 0.0009). However, there was no significant difference in age ≥50 years (OR 0.96; 95% CI: 0.71–1.29, p = 0.78), combined TRW ≥1000 g (OR 1.04; 95% CI: 0.43–2.50, p = 0.93).ConclusionsBMI ≥30 kg/m2 and smoking increase the risk of complications. Persons who are obese or irradiated are more likely to develop infections, and smokers experienced a higher incidence of wound dehiscence than did nonsmokers. However, patients aged ≥50 years and TRW ≥1000 g are not associated with complications from RM.

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Anterior cervical discectomy versus corpectomy for multilevel cervical spondylotic myelopathy: a meta-analysis

Cited by 58 publications

References 45 publications

A systematic review of the use of expandable cages in the cervical spine

A systematic review of the use of expandable cages in the cervical spine

Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy

Risk Factors for Complications after Reduction Mammoplasty: A Meta-Analysis

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