Less superior adjacent syndrome and lower reoperation rate. Medium- and long-term results of cervical arthroplasty versus anterior cervical arthrodesis: Systematic review and meta-analysis of randomized clinical trials.

Autor: Núñez JH; Unidad de Columna Vertebral, Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de Mutua Terrassa, Tarrasa (Barcelona), España; Unidad de Columna, Artro-Esport, Centro Médico Teknon, Barcelona, España. Electronic address: hassan2803med@gmail.com., Escudero B; Unidad de Columna Vertebral, Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de Mutua Terrassa, Tarrasa (Barcelona), España., Montenegro JD; Unidad de Columna Vertebral, Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de Mutua Terrassa, Tarrasa (Barcelona), España., Jiménez-Jiménez MJ; Unidad de Columna Vertebral, Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de Mutua Terrassa, Tarrasa (Barcelona), España., Martínez-Peña J; Unidad de Columna Vertebral, Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de Mutua Terrassa, Tarrasa (Barcelona), España., Surroca M; Unidad de Columna Vertebral, Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de Mutua Terrassa, Tarrasa (Barcelona), España., Bosch-García D; Unidad de Columna Vertebral, Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de Mutua Terrassa, Tarrasa (Barcelona), España; Grup Traumatologic de Catalunya, Barcelona, España.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cirugia ortopedica y traumatologia [Rev Esp Cir Ortop Traumatol] 2024 Mar-Apr; Vol. 68 (2), pp. 168-178. Date of Electronic Publication: 2023 Jul 07.
DOI: 10.1016/j.recot.2023.06.016
Abstrakt: Objective: To compare medium- and long-term postoperative surgical results, especially the adjacent syndrome rate, adverse event rate, and reoperation rate, of patients operated on with cervical arthroplasty or anterior cervical arthrodesis in published randomized clinical trials (RCTs), at one cervical level.
Methods: Systematic review and meta-analysis. Thirteen RCTs were selected. The clinical, radiological and surgical results were analyzed, taking the adjacent syndrome rate and the reoperation rate as the primary objective of the study.
Results: Two thousand nine hundred and sixty three patients were analyzed. The cervical arthroplasty group showed a lower rate of superior adjacent syndrome (P<0.001), lower reoperation rate (P<0.001), less radicular pain (P=0.002), and a better score of neck disability index (P=0.02) and SF-36 physical component (P=0.01). No significant differences were found in the lower adjacent syndrome rate, adverse event rate, neck pain scale, or SF-36 mental component. A range of motion of 7.91 degrees was also found at final follow-up, and a heterotopic ossification rate of 9.67% in patients with cervical arthroplasty.
Conclusion: In the medium and long-term follow-up, cervical arthroplasty showed a lower rate of superior adjacent syndrome and a lower rate of reoperation. No statistically significant differences were found in the rate of inferior adjacent syndrome or in the rate of adverse events.
(Copyright © 2023 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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