IR@PKUHSC  > 北京大学第三临床医学院  > 骨科
学科主题临床医学
Anterior approach versus posterior approach for the treatment of multilevel cervical spondylotic myelopathy: a systemic review and meta-analysis
Zhu, Bin1,2; Xu, Yilan1; Liu, Xiaoguang2; Liu, Zhongjun2; Dang, Gengting2
关键词Anterior Approach Posterior Approach Cervical Spondylotic Myelopathy Systemic Review Meta-analysis
刊名EUROPEAN SPINE JOURNAL
2013-07-01
DOI10.1007/s00586-013-2817-2
22期:7页:1583-1593
收录类别SCI
文章类型Review
WOS标题词Science & Technology
类目[WOS]Clinical Neurology ; Orthopedics
研究领域[WOS]Neurosciences & Neurology ; Orthopedics
关键词[WOS]TERM FOLLOW-UP ; SUBTOTAL CORPECTOMY ; LAMINOPLASTY ; FUSION ; ADJACENT ; SPINE ; DISKECTOMY ; SURGERY ; COHORT
英文摘要

To compare the clinical outcomes, complications, and surgical trauma between anterior and posterior approaches for the treatment of multilevel cervical spondylotic myelopathy.

Systematic review and meta-analysis.

We searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases for randomized controlled trials or non-randomized controlled trials that compared anterior and posterior surgical approaches for the treatment of multilevel cervical spondylotic myelopathy. Exclusion criteria were non-controlled studies, combined anterior and posterior surgery, follow-up < 1 year, cervical kyphosis > 15A degrees, and cervical myelopathy caused by ossification of the posterior longitudinal ligament. The main end points included: recovery rate; Japanese Orthopedic Association (JOA) score; reoperation rate; complication rate; blood loss; and operation time. Subgroup analysis was conducted according to the mean number of surgical segments.

A total of eight studies were included in the meta-analysis; none of which were randomized controlled trials. All of the selected studies were of high quality as indicated by the Newcastle-Ottawa scale. In five studies involving 351 patients, the preoperative JOA score was similar between the anterior and posterior groups [P > 0.05, WMD: -0.00 (-0.56, 0.56)]. In four studies involving 268 patients, the postoperative JOA score was higher in the anterior group compared with the posterior group [P < 0.05, WMD: 0.79 (0.16, 1.42)]. For recovery rate, there was significant heterogeneity among the four studies involving 304 patients, hence, only descriptive analysis was performed. In seven studies involving 447 patients, the postoperative complication rate was significant higher in the anterior group compared with the posterior group [P < 0.05, odds ratio: 2.60 (1.63, 4.15)]. Of the 245 patients in the 8 studies who received anterior surgery, 21 (8.57 %) received reoperation. Of the 285 patients who received posterior surgery, only 1 (0.3 %) received reoperation. The reoperation rate was significantly higher in the anterior group compared with the posterior group (P < 0.001). In the 3 studies involving 236 patients compared subtotal corpectomy and laminoplasty/laminectomy, blood loss and operation time were significantly higher in the anterior subtotal corpectomy group compared with the posterior laminoplasty/laminectomy group [P < 0.05, WMD: 150.10 (63.53, 236.66) and P < 0.05, WMD: 59.17 (45.69, 72.66)].

The anterior approach was associated with better postoperative neural function than the posterior approach in the treatment of multilevel cervical spondylotic myelopathy. There was no apparent difference in the neural function recovery rate. The complication and reoperation rates were significantly higher in the anterior group compared with the posterior group. The surgical trauma associated with corpectomy was significantly higher than that associated with laminoplasty/laminectomy.

语种英语
WOS记录号WOS:000321240600021
引用统计
被引频次:42[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/50913
专题北京大学第三临床医学院_骨科
作者单位1.Tsinghua Univ, Affiliated Beijing Tsinghua Hosp, Beijing 100084, Peoples R China
2.Peking Univ, Hosp 3, Dept Orthopaed, Beijing 100191, Peoples R China
推荐引用方式
GB/T 7714
Zhu, Bin,Xu, Yilan,Liu, Xiaoguang,et al. Anterior approach versus posterior approach for the treatment of multilevel cervical spondylotic myelopathy: a systemic review and meta-analysis[J]. EUROPEAN SPINE JOURNAL,2013,22(7):1583-1593.
APA Zhu, Bin,Xu, Yilan,Liu, Xiaoguang,Liu, Zhongjun,&Dang, Gengting.(2013).Anterior approach versus posterior approach for the treatment of multilevel cervical spondylotic myelopathy: a systemic review and meta-analysis.EUROPEAN SPINE JOURNAL,22(7),1583-1593.
MLA Zhu, Bin,et al."Anterior approach versus posterior approach for the treatment of multilevel cervical spondylotic myelopathy: a systemic review and meta-analysis".EUROPEAN SPINE JOURNAL 22.7(2013):1583-1593.
条目包含的文件
条目无相关文件。
个性服务
推荐该条目
保存到收藏夹
查看访问统计
导出为Endnote文件
谷歌学术
谷歌学术中相似的文章
[Zhu, Bin]的文章
[Xu, Yilan]的文章
[Liu, Xiaoguang]的文章
百度学术
百度学术中相似的文章
[Zhu, Bin]的文章
[Xu, Yilan]的文章
[Liu, Xiaoguang]的文章
必应学术
必应学术中相似的文章
[Zhu, Bin]的文章
[Xu, Yilan]的文章
[Liu, Xiaoguang]的文章
相关权益政策
暂无数据
收藏/分享
所有评论 (0)
暂无评论
 

除非特别说明,本系统中所有内容都受版权保护,并保留所有权利。