[Comparison of the long-term outcomes of total arthroplasty and anterior spinal fusion in the treatment of cervical degenerative disc disease: a metaanalysis].

Autor:	Byval'tsev VA; Irkutsk State Medical University, Irkutsk, Russia; Railway Clinical Hospital at the Irkutsk-Passenger Station, Irkutsk, Russia; Irkutsk Research Center of Surgery and Traumatology, Irkutsk, Russia; Irkutsk State Medical Academy of Continuing Education, Irkutsk, Russia., Stepanov IA; Irkutsk State Medical University, Irkutsk, Russia., Aliev MA; Irkutsk State Medical University, Irkutsk, Russia., Aglakov BM; Irkutsk State Medical University, Irkutsk, Russia., Yusupov BR; Irkutsk State Medical University, Irkutsk, Russia., Konovalov NA; Burdenko Neurosurgical Center, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko [Zh Vopr Neirokhir Im N N Burdenko] 2019; Vol. 83 (6), pp. 100-110.
DOI:	10.17116/neiro201983061100
Abstrakt:	Aim: The study aim was to perform a meta-analysis based on the results of randomized clinical trials comparing long-term outcomes of total intervertebral disc arthroplasty (TA) and anterior cervical spinal fusion (ACSF) in the surgical treatment of cervical degenerative disc disease. Material and Methods: We searched Pubmed, EMBASE, ELibrary, and Cochrane Library databases for randomized clinical trials reported between 2008 and August 2018. The relative risk and 95% confidence interval were calculated for dichotomous variables; for continuous variables, we used the standardized mean difference and their 95% CI with application of a random effects model. Results: The metaanalysis involved 9 randomized controlled clinical trials including the long-term outcomes of surgical treatment in 2,439 patients. A pooled analysis of the data showed that regression of neurological symptoms (p<0.00001), improvement in the quality of life of patients (Neck Disability Index), and lower pain severity (visual analogue scale for upper extremities) were significantly more often observed (p=0.02) in the group of TA patients. In addition, the TA technique was characterized by a statistically significantly lower rate of re-surgery (p<0.0005) and degeneration of the superjacent segment (p<0.0001), with the rate of adverse events being slightly increased (p=0.04). Conclusion: Compared to anterior cervical spinal fusion, TA of cervical intervertebral discs is characterized by significantly better clinical efficacy in patients with cervical degenerative disc disease in the long-term postoperative follow-up.
Databáze:	MEDLINE
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