摘要
目的系统评价颈前路椎间盘切除椎体间植骨融合术(ACDF)与颈前路椎体次全切除椎体间植骨融合术(ACCF)治疗相邻3个节段脊髓型颈椎病的疗效及安全性。方法计算机检索PubMed、Embase、Cochrane Library、中国知网、中国生物医学文献数据库和万方数据库,收集应用ACDF与ACCF治疗相邻3节段脊髓型颈椎病的研究。筛选文献并行质量评价后,使用RevMan5.3软件进行Meta分析。结果共纳入9篇文献。与ACCF组相比,ACDF组手术出血量更少,内置物融合率更高,术后C5神经根麻痹发生率及日本骨科协会(JOA)评分更低,术后颈椎Cobb角更大(均P<0.05);两组的手术时间、手术相关并发症总体发生率、术后脑脊液漏发生率差异无统计学意义(均P>0.05)。结论对于相邻3节段脊髓型颈椎病,ACCF的JOA评分优于ACDF,但ACDF在减少手术出血量及术后C5神经根麻痹、提高内置物融合率、恢复术后颈椎生理曲度方面优于ACCF。
Objective To systematically review the efficacy and safety of anterior cervical discectomy and fusion(ACDF) versus anterior cervical corpectomy and fusion(ACCF) in the treatment of adjacent three-level cervical spondylotic myelopathy(CSM). Methods A computer retrieval was performed in PubMed, Embase, Cochrane Library, CNKI, CBM and Wanfang database to collect the studies on applying ACDF and ACCF to adjacent three-level CSM treatment. After literature screening and quality assessment, Meta-analysis was performed using RevMan5.3 software. Results A total of 9 studies were enrolled. Compared with the ACCF group, the ACDF group had less operative blood loss, higher infusion rate of implants, lower incidence rate of postoperative C5 radicular paralysis and lower Japanese Orthopaedic Association(JOA) score, and larger postoperative cervical Cobb angle(all P<0.05);there were no statistically significant differences in operation duration,total incidence rate of operation-related complications or postoperative cerebrospinal fluid leakage between the two groups(all P>0.05). Conclusion For adjacent three-level CSM, ACCF achieves a better JOA score as compared with ACDF, however, ACDF is superior to ACCF in aspects of operative bleeding and postoperative C5 radicular paralysis reduction, improvement in implants infusion rate, and postoperative cervical physiological curvature recovery.
作者
张磊
鲍杰
唐晓菊
刘汝专
刘锐
龚德飞
黄立
魏纪湖
ZHANG Lei;BAO Jie;TANG Xiao-ju;LIU Ru-zhuan;LIU Rui;GONG De-fei;HUANG Li;WEI Ji-hu(Graduate School,Guangxi University of Chinese Medicine,Nanning 530001,China;Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530011,China)
出处
《广西医学》
CAS
2020年第5期608-613,共6页
Guangxi Medical Journal
基金
全国名老中医传承工作室建设项目[桂卫中医发(2016)11号]
广西中医药大学校级重点课题(2015ZD002)。
