Anterior controllable antedisplacement and fusion for the treatment of cervical ossification of posterior longitudinal ligament: a meta-analysis
10.3760/cma.j.cn121113-20240818-00456
- VernacularTitle:颈椎前路椎体骨化物复合体前移融合术治疗后纵韧带骨化的meta分析
- Author:
Guotai WANG
1
;
Haoyu FENG
1
;
Hua WU
1
Author Information
1. 山西医科大学第三医院（山西白求恩医院，山西医学科学院，同济山西医院）骨科，太原 030032
- Publication Type:Journal Article
- Keywords:
Cervical vertebrae;
Ossification of posterior longitudinal ligament;
Decompression, surgical;
Meta-analysis
- From:
Chinese Journal of Orthopaedics
2024;44(23):1541-1548
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the efficacy and safety of anterior controllable antedisplacement and fusion (ACAF) in the treatment of cervical ossification of posterior longitudinal ligament.Methods:Clinical studies on ACAF treatment for ossification of the posterior longitudinal ligament were searched in CNKI, Wanfang Data Knowledge Service Platform, VIP, Chinese Medical Journal Full-Text Database, PubMed, Embase, Web of Science, and Google Scholar. The operation time, intraoperative blood loss, Japanese Orthopaedic Association (JOA) score, cervical lordosis Cobb angle, and postoperative complications were extracted, and the included studies were analyzed by meta-analysis. The fixed-effects model was used for analysis when heterogeneity between groups was small, and the random-effects model was used when heterogeneity between groups was large. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the retrospective studies.Results:A total of 7 studies involving 539 patients were included in the meta-analysis, including 280 patients in the ACAF group and 259 patients in the traditional decompression and internal fixation group. The results of meta-analysis showed that the operation time of the ACAF group was longer than that of the traditional decompression and internal fixation group [ WMD=29.60, 95% CI(9.60, 49.60), P<0.001] and the intraoperative blood loss was less than that of the traditional decompression and internal fixation group [ WMD=-25.80, 95% CI(-32.11, -19.48), P<0.001]. The cervical JOA score [ WMD=0.82, 95% CI(0.35, 1.29), P<0.001] and Cobb angle of lordosis [ WMD=7.91, 95% CI(6.02, 9.80), P<0.001] in the traditional decompression and internal fixation group were higher than those in the traditional decompression and internal fixation group. The incidence of postoperative complications in the ACAF group was lower than that in the traditional decompression and internal fixation group [ OR=0.23, 95% CI(0.13, 0.38), P<0.001]. Conclusion:ACAF for the treatment of cervical posterior longitudinal ligament ossification showed less intraoperative bleeding, better postoperative cervical spine function and imaging indexes than traditional decompression and internal fixation, and a lower postoperative complication rate.
