Anterior cervical decompression and fusion（ACDF） with cage placement or autograft for cervical myelopathy，a meta-analysis

English Keywords:Cervical myelopathy  Cage  Autograft  Meta-analysis

English Abstract:

  【Abstract】 Objective：To investigate the efficacy of anterior cervical decompression and fusion（ACDF） with cage placement or autograft for cervical myelopathy.Method：A computer-based online search of Medline，EMBASE，Cochrane CENTRAL（1st Quarter 2011），ScienceDirect，OVID，SpringerLink and China Biological Medicine Database，and hand search of several related journals were performed.The included trials were screened out according to the criterion of inclusion and exclusion.The quality of included trials was evaluated.Data were extracted by two reviewers independently.RevMan 5.1.1 was used for data analysis.The following indexes were used to compare the results：mean operation time，blood loss，inpatient stay，complication rate，fusion rate，excellent to good rate and donor site pain.Result：11 studies involving 1139 patients were included.The levels of included studies were very high.The results of Meta-analysis indicated that statistically significant differences were noted between two procedures for the blood loss[MD=-8.42，95%CI（-15.59，-1.25），P=0.02]，inpatient stay[MD=-0.31，95%CI（-0.62，-0.01），P=0.05]，complication rate[OR=0.56，95%CI（0.37，0.83），P=0.004] and donor site pain[OR=0.06，95%CI（0.01，0.27），P=0.0002].While no difference were noted for the mean operation time[MD=-14.55，95%CI（-30.79，1.69），P=0.08]，fusion rate[OR=1.44，95%CI（0.70，2.96），P=0.32] and excellent and good rate[OR=1.39，95%CI（0.92，2.09），P=0.12].Conclusion：Both cage and autograft fusion are effective for cervical myelopathy.Compared with autograft，cage can decrease blood loss，shorten inpatient time and decrease the rate of complications，especially the donor site pain.As for the mean operation time，fusion rate and excellent to good rate，2 procedures are equal.