title: [Comparison of total disc replacement versus fusion for lumbar degenerative disc disease: a Meta-analysis of randomized controlled trials].
abstract: OBJECTIVE
  To compare the related clinical outcomes of total disc replacement (TDR) versus fusion in management of lumbar degenerative disc disease (LDDD)and provide available basis for choice of surgical procedure.
  
  
  METHODS
  Computer systematically researched PubMed,EMBase, COCHRANE Library, CBMWin, CNKI, VIP databases for randomized controlled trials comparing TDR and fusion for LDDD. Data were searched until October 2013. The available statistical data was extracted after methodological assessment. The statistical soft RevMan 5.1 was used to analyze the results.
  
  
  RESULTS
  Total 1 658 cases of patients in 6 studies were conducted, including 543 cases of fusion and 1 115 cases of TDR. The results of Meta-analysis showed that TDR was superior to fusion in term of visual analogue scale (VAS) (OR = -3.33, 95%CI:-5.94--0.71, P = 0.01) , Oswestry disability index (ODI) (OR = -5.21, 95%CI:-7.51--2.92, P = 0.00) , complication (OR = 0.45, 95%CI:0.21-0.95, P = 0.04) . There were no statistically difference regarding operating time, blood loss and reoperation (P > 0.05). However, there was no difference in term of complication in two-year and five-year sub-analysis.
  
  
  CONCLUSIONS
  Regardless TDR may be more effective comparable to lumbar fusion at the immediate postoperative time, vigorous evidence is still requisite to certify the result in long-term follow-up.
authors.affiliation: Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Liwei
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Tianyi
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin 300052, China. Email: fengsq321@sina.com.
authors.forename: Shiqing
authors.initials: S
authors.lastname: Feng
authors.affiliation: Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Daigui
authors.initials: D
authors.lastname: Cao
authors.affiliation: Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Yanjun
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D013123:Spinal Fusion / Q000379:methods*; D059145:Total Disc Replacement; D016896:Treatment Outcome