• Shan-Wen Xiao, Hua Jiang, Li-Jing Yang, and Zeng-Ming Xiao.
• Department of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, Shuangyong Road No. 6, Nanning, 530021, China.
• Eur Spine J. 2015 Jan 1; 24 (1): 31-9.

PurposeThis is a meta-analysis to compare the results between anterior cervical discectomy fusion (ACDF) and anterior cervical corpectomy fusion (ACCF) for the patients with multilevel cervical spondylotic myelopathy (MCSM).MethodsSystematic review and meta-analysis of cohort studies between ACDF with plate fixation and ACCF with plate fixation for the treatment of MCSM. An extensive search of literature was performed in PubMed, Mediline, Embase and the Cochrane library. The following outcome measures were extracted: JOA scores, fusion rate, cervical lordosis (C2-7), complications, blood loss and operation time. Data analysis was conducted with RevMan 5.0.ResultsFour cohorts (six studies) involving 258 patients were included in this study. The pooled analysis showed that there was no significant difference in the postoperative JOA score [WMD = -0.14 (-1.37, 1.10), P = 0.83], fusion rate [OR = 0.84 (0.15, 4.86), P = 0.85] between two group. However, there was significant difference in the cervical lordosis [WMD = 3.38 (2.52, 4.23), P < 0.00001], surgical complication rate and instrument related complication rate (P = 0.01, 0.005 respectively), blood loss [WMD = -52.53 (-73.53, -31.52), P < 0.00001], and operation time [WMD = -14.10 (-20.27, -7.93), P < 0.00001].ConclusionsAs compared with ACCF with plate fixation, ACDF with plate fixation showed no significant differences in terms of postoperative JOA score, fusion rate, but better improved cervical lordosis, lower complication and smaller surgical trauma. As the limitations of small sample and short follow-up in this study, it still could not be identified whether ACDF with plate fixation is more effective and safer than ACCF with plate fixation.

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