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Multilevel cervical disc replacement versus multilevel anterior discectomy and fusion: A meta-analysis.

Abstract Cervical disc replacement (CDR) has been developed as an alternative surgical procedure to anterior cervical discectomy and fusion (ACDF) for the treatment of single-level cervical degenerative disc disease. However, patients with multilevel cervical degenerative disc disease (MCDDD) are common in our clinic. Multilevel CDR is less established compared with multilevel ACDF. This study aims to compare the outcomes and evaluate safety and efficacy of CDR versus ACDF for the treatment of MCDDD.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28422837
OWN - NLM
STAT- In-Process
DA  - 20170419
LR  - 20170419
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 16
DP  - 2017 Apr
TI  - Multilevel cervical disc replacement versus multilevel anterior discectomy and
      fusion: A meta-analysis.
PG  - e6503
LID - 10.1097/MD.0000000000006503 [doi]
AB  - BACKGROUND: Cervical disc replacement (CDR) has been developed as an alternative 
      surgical procedure to anterior cervical discectomy and fusion (ACDF) for the
      treatment of single-level cervical degenerative disc disease. However, patients
      with multilevel cervical degenerative disc disease (MCDDD) are common in our
      clinic. Multilevel CDR is less established compared with multilevel ACDF. This
      study aims to compare the outcomes and evaluate safety and efficacy of CDR versus
      ACDF for the treatment of MCDDD. METHODS: A meta-analysis was performed for
      articles published up until August 2016. Randomized controlled trials (RCTs) and 
      prospective comparative studies associated with the use of CDR versus ACDF for
      the treatment of MCDDD were included in the current study. Two reviewers
      independently screened the articles and data following the Preferred Reporting
      Items for Systematic Reviews and Meta-Analysis statement. RESULTS: Seven studies 
      with 702 enrolled patients suffering from MCDDD were retrieved. Patients who
      underwent CDR had similar operative times, blood loss, Neck Disability Index
      (NDI) scores, and Visual Analog Scale (VAS) scores compared to patients who
      underwent ACDF. Patients who underwent CDR had greater overall motion of the
      cervical spine and the operated levels than patients who underwent ACDF. Patients
      who underwent CDR also had lower rates of adjacent segment degeneration (ASD).
      The rate of adverse events was significantly lower in the CDR group. CONCLUSION: 
      CDR may be a safe and effective surgical strategy for the treatment of MCDDD.
      However, there is insufficient evidence to draw a strong conclusion due to
      relatively low-quality evidence. Future long-term, multicenter, randomized, and
      controlled studies are needed to validate the safety and efficacy of multilevel
      CDR.
FAU - Wu, Ting-Kui
AU  - Wu TK
AD  - Department of Orthopedic Surgery, West China Hospital, Sichuan University,
      Sichuan, China.
FAU - Wang, Bei-Yu
AU  - Wang BY
FAU - Meng, Yang
AU  - Meng Y
FAU - Ding, Chen
AU  - Ding C
FAU - Yang, Yi
AU  - Yang Y
FAU - Lou, Ji-Gang
AU  - Lou JG
FAU - Liu, Hao
AU  - Liu H
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/04/20 06:00
MHDA- 2017/04/20 06:00
CRDT- 2017/04/20 06:00
AID - 10.1097/MD.0000000000006503 [doi]
AID - 00005792-201704210-00018 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Apr;96(16):e6503. doi: 10.1097/MD.0000000000006503.

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