Zhai Shuchao, Li Aimin, Li Xiang, Wu Xingguo
Department of Orthopedics, Tianjin Fifth Central Hospital, Tianjin, China.
Medicine (Baltimore). 2020 May;99(19):e20143. doi: 10.1097/MD.0000000000020143.
The present study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.
The present study aimed to conduct a systematic review of overlapping meta-analyses comparing ACDR with fusion for treating CDDD in order to assist decision makers in their selection among conflicting meta-analyses and to provide treatment recommendations based on the best available evidence.
Although several meta-analyses have been performed to compare total disc replacement (TDR) and fusion for treating cervical degenerative disc disease (CDDD), their findings are inconsistent.
Multiple databases were comprehensively searched for meta-analyses comparing TDR with fusion for treating CDDD. The meta-analyses that comprised only randomized controlled trials (RCTs) were included. Two authors independently assessed the meta-analysis study quality and extracted the data. The Jadad decision algorithm was used to ascertain which meta-analysis studies represented the best evidence.
A total of 14 meta-analysis studies were included. All these studies only included RCTs and were determined as Level-II evidence.
Cervical disc arthroplasty was superior compared to anterior discectomy and fusion for the treatment of symptomatic cervical disc disease.
本研究遵循系统评价与Meta分析的首选报告项目（PRISMA）声明进行。
本研究旨在对比较人工颈椎间盘置换术（ACDR）与融合术治疗颈椎间盘退变疾病（CDDD）的重叠Meta分析进行系统评价，以帮助决策者在相互矛盾的Meta分析中做出选择，并基于现有最佳证据提供治疗建议。
尽管已经进行了多项Meta分析来比较全椎间盘置换术（TDR）与融合术治疗颈椎间盘退变疾病（CDDD），但其结果并不一致。
全面检索多个数据库，查找比较TDR与融合术治疗CDDD的Meta分析。纳入仅包含随机对照试验（RCT）的Meta分析。两位作者独立评估Meta分析研究质量并提取数据。使用Jadad决策算法确定哪些Meta分析研究代表最佳证据。
共纳入14项Meta分析研究。所有这些研究仅纳入RCT，并被确定为二级证据。
在治疗有症状的颈椎间盘疾病方面，颈椎间盘置换术优于前路椎间盘切除融合术。
