Is anterior cervical plating necessary for cage constructs in anterior cervical discectomy and fusion surgery for cervical degenerative disorders? Evidence-based on the systematic overview of meta-analyses

被引:2
作者
Viswanathan, Vibhu Krishnan [1 ,2 ]
Muthu, Sathish [2 ,3 ]
机构
[1] Univ Calgary, Dept Musculoskeletal Oncol, Calgary, AB, Canada
[2] Orthopaed Res Grp, Coimbatore, Tamil Nadu, India
[3] Govt Med Coll, Dept Orthopaed, Dindigul, India
关键词
ACDF; Standalone cage; Cage with plate; Recommendation; Systematic review; FIXATION; DISEASE; SPACER;
D O I
10.1016/j.wnsx.2023.100185
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study design: Systematic review of meta-analyses. Objective: To perform a systematic review of meta-analyses to compare the clinical and radiological outcomes following anterior cervical discectomy and fusion with stand-alone cage (SAC) and anterior cervical cage-plate constructs (ACCPC). Methods: The systematic overview was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and reported as per Cochrane Handbook for Systematic Reviews of Interventions following the methodology described in reporting Overview of reviews. Results: Based on the available level-1 evidence, SAC offers significantly better benefits over ACCPC, in terms of shorter operative time (p < 0.00001; I-2 = 0%), lower blood loss (p = 0.01; I-2 = 0%), lesser rates of post-operative dysphagia (p = 0.02; I-2 = 0%), reduced overall expenditure (p = 0.001) and long-term adjacent segment degeneration (ASD)/anterior longitudinal ligament ossification (ALO; p = 0.0003; I-2 = 0%). There is no significant difference between the two constructs with regard to fusion rates, functional outcome scores, follow-up radiological sagittal alignment parameters or cage subsidence. Conclusion: Based on the available evidence, SAC constructs in ACDF reduce blood loss, decreases operative time, mitigates post-operative dysphagia, lessens hospital-related expenditure and minimises long-term ASD rates.
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页数:9
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