Yao Qiang, Liang Feng, Xia Yang, Jia Changqing
The First Orthopedics Department, Shengjing Hospital Affiliated to China Medical University, Shenyang, 110004, China.
Arch Orthop Trauma Surg. 2016 Mar;136(3):297-304. doi: 10.1007/s00402-015-2337-0. Epub 2015 Sep 28.
To evaluate the efficacy and safety of total disc arthroplasty (TDA) and anterior cervical discectomy and fusion (ACDF) for treating cervical degenerative diseases.
We conducted a comprehensive search in the electronic databases including Pubmed, Medline, EBSCO, Springer, Ovid, CNKI and Cochrane Database of Systematic Reviews. Two independent reviewers performed the data extraction from archives. All data were performed with Review Manager 5.2 software. The relative risk (RR) and its 95% confidence interval (CI) were calculated for count data. Standardized mean difference (SMD) and corresponding 95% CI for continuous outcomes were pooled.
After applying inclusion and exclusion criteria, nine papers were included in meta-analyses. The results of the meta-analysis indicated better neurological success, better overall success, lower incidence of secondary surgical procedures and lower incidence of secondary surgical procedures in TDA group than in ACDF group. After removing a study with considerable weight, TDA group displayed lower incidence of dysphagia and dysphonia than ACDF group.
This meta-analysis revealed that the clinical outcomes of TDA are equivalent or superior to ACDF.
评估全椎间盘置换术（TDA）和颈椎前路椎间盘切除融合术（ACDF）治疗颈椎退行性疾病的疗效和安全性。
我们在包括Pubmed、Medline、EBSCO、Springer、Ovid、中国知网和Cochrane系统评价数据库在内的电子数据库中进行了全面检索。两名独立的评审人员从档案中提取数据。所有数据均使用Review Manager 5.2软件进行分析。计数资料计算相对危险度（RR）及其95%置信区间（CI）。对连续变量结果合并标准化均数差（SMD）及相应的95%CI。
应用纳入和排除标准后，9篇论文纳入荟萃分析。荟萃分析结果表明，TDA组在神经功能改善、总体成功率、二次手术发生率及吞咽困难和发音障碍发生率方面均优于ACDF组。剔除一篇权重较大的研究后，TDA组吞咽困难和发音障碍的发生率低于ACDF组。
该荟萃分析表明，TDA的临床疗效等同于或优于ACDF。
