title: Comparison of Hybrid Surgery Incorporating Anterior Cervical Discectomy and Fusion and Artificial Arthroplasty versus Multilevel Fusion for Multilevel Cervical Spondylosis: A Meta-Analysis.
abstract: BACKGROUND Few studies have reported the safety and efficacy of hybrid surgery (HS), and some of the studies comparing HS with ACDF have reported conflicting results. We conducted this meta-analysis to clarify the advantages of HS in the treatment of multilevel cervical spondylosis. MATERIAL AND METHODS We performed a systematic literature search in PubMed, Medline, and CNKI to identify relevant controlled trials published up to October 2015. The standardized mean difference (SMD) and 95% confidence interval (95% CI) of the perioperative parameters, visual analogue scale pain score (VAS), neck disability index (NDI), and range of motion (ROM) of C2-C7 and adjacent segments were calculated. We also analyzed complications and Odom scale scores using risk difference (RD) and 95% CI. RESULTS In total, 7 studies were included. The pooled data exhibited significant differences in blood loss between the 2 groups. However, there was no evidence indicating significant differences in operation time, complications, VAS, NDI, or Odom scale scores. Compared with the ACDF group, the HS group exhibited significantly protected C2-C7 ROM and reduced adjacent-segment ROM. CONCLUSIONS The safety of HS may be as good as that of ACDF. Furthermore, HS is superior to ACDF in conserving cervical spine ROM and decreasing adjacent-segment ROM. However, the results should be accepted cautiously due to the limitations of the study. Studies with larger sample sizes and longer follow-up periods are required to confirm and update the results of the present study.
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China (mainland).
authors.forename: Leyuan
authors.initials: L
authors.lastname: Zang
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China (mainland).
authors.forename: Min
authors.initials: M
authors.lastname: Ma
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China (mainland).
authors.forename: Jianxin
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China (mainland).
authors.forename: Hao
authors.initials: H
authors.lastname: Qiu
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China (mainland).
authors.forename: Bo
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China (mainland).
authors.forename: Tongwei
authors.initials: T
authors.lastname: Chu
mesh_terms: D001178:Arthroplasty / Q000379:methods; D002574:Cervical Vertebrae / Q000601:surgery; D017586:Diskectomy / Q000379:methods; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular; D013123:Spinal Fusion / Q000379:methods; D055009:Spondylosis / Q000601:surgery*; D016896:Treatment Outcome