title: Anterior cervical discectomy versus corpectomy for multilevel cervical spondylotic myelopathy: a meta-analysis.
abstract: OBJECTIVE
  This 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).
  
  
  METHODS
  Systematic 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.
  
  
  RESULTS
  Four 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].
  
  
  CONCLUSIONS
  As 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.
authors.affiliation: Department of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, Shuangyong Road No. 6, Nanning, 530021, China.
authors.forename: Shan-Wen
authors.initials: SW
authors.lastname: Xiao
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.forename: Li-Jing
authors.initials: LJ
authors.lastname: Yang
authors.forename: Zeng-Ming
authors.initials: ZM
authors.lastname: Xiao
mesh_terms: D001860:Bone Plates; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy / Q000379:methods*; D006801:Humans; D015233:Models, Statistical; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D055009:Spondylosis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome