Floyd T, Ohnmeiss D
Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Eur Spine J. 2000 Oct;9(5):398-403. doi: 10.1007/s005860000160.
We performed a metaanalysis of one- and two-level anterior cervical interbody fusion (ACDF) on data derived from published, peer-reviewed journal articles to determine whether there is a difference in fusion rate, graft complications, or clinical outcome in patients undergoing ACDF according to whether autograft or allograft was used. ACDF is a common procedure for cervical spondylotic radiculopathy. Most published studies comparing autograft and allograft have not demonstrated any difference between grafts. The medical literature dating from 1955 was reviewed. Of 395 titles, only four studies comparing autograft with allograft in ACDF were appropriate for this analysis. The data from these studies--310 patients and 379 intervertebral levels were pooled and statistical methods were applied. For both one- and two-level ACDF, autograft demonstrated a higher rate of radiographic union and a lower incidence of graft collapse. It was not possible to ascertain whether autograft is clinically superior to allograft. Although autograft has a higher fusion rate than allograft, clinical results do not depend solely on radiographic results. The risk of graft site morbidity and patient preference should be considered when choosing the type of graft for this operation.
我们对已发表的、经过同行评审的期刊文章中的数据进行了一项关于单节段和双节段颈椎前路椎间融合术（ACDF）的荟萃分析，以确定根据使用的是自体骨移植还是同种异体骨移植，接受ACDF的患者在融合率、移植物并发症或临床结果方面是否存在差异。ACDF是治疗神经根型颈椎病的常见手术。大多数比较自体骨移植和同种异体骨移植的已发表研究并未显示出移植物之间存在任何差异。我们回顾了1955年以来的医学文献。在395篇标题中，只有四项比较ACDF中自体骨移植与同种异体骨移植的研究适合该分析。汇总了这些研究中的数据——310例患者和379个椎间节段，并应用了统计方法。对于单节段和双节段ACDF，自体骨移植均显示出更高的影像学融合率和更低的移植物塌陷发生率。无法确定自体骨移植在临床上是否优于同种异体骨移植。虽然自体骨移植的融合率高于同种异体骨移植，但临床结果并不完全取决于影像学结果。在为该手术选择移植物类型时，应考虑移植物部位发病的风险和患者的偏好。
