Wang Ziqi, Luo Gan, Yu Hongwei, Zhao Hui, Li Tianhao, Yang Houzhi, Sun Tianwei
School of Medicine, Nankai University, Tianjin, China.
Graduate School of Tianjin Medical University, Tianjin, China.
Front Surg. 2023 Feb 21;10:1124423. doi: 10.3389/fsurg.2023.1124423. eCollection 2023.
This study aims to evaluate the clinical efficacy and safety between Discover cervical disc arthroplasty (DCDA) and anterior cervical discectomy and fusion (ACDF) in Cervical degenerative disc diseases.
Two researchers independently conducted a search of PubMed, EMBASE, and Cochrane Central Register of Controlled Trails (CENTRAL) for randomized controlled trials (RCTs) following the Cochrane methodology guidelines. A fixed-effects or random-effects model was applied based on different heterogeneity. Review Manager (Version 5.4.1) software was used to perform data analysis.
A total of 8 RCT studies were included in this meta-analysis. The results indicate that the DCDA group had a higher incidence of reoperation ( = 0.03) and a lower incidence of ASD ( = 0.04) than the CDA group. There was no significant difference between two groups regarding NDI score ( = 0.36), VAS ARM score ( = 0.73), VAS NECK score ( = 0.63), EQ-5D score ( = 0.61) and dysphagia incidence (0.18).
DCDA and ACDF have similar results in terms of NDI scores, VAS scores, EQ-5D scores, and dysphagia. In addition, DCDA can reduce the risk of ASD but increases the risk of reoperation.
本研究旨在评估颈椎间盘置换术（DCDA）与颈椎前路椎间盘切除融合术（ACDF）治疗颈椎间盘退变疾病的临床疗效和安全性。
两名研究人员按照Cochrane方法指南，独立检索PubMed、EMBASE和Cochrane对照试验中心注册库（CENTRAL），查找随机对照试验（RCT）。根据不同的异质性应用固定效应或随机效应模型。使用Review Manager（版本5.4.1）软件进行数据分析。
本荟萃分析共纳入8项RCT研究。结果表明，与ACDF组相比，DCDA组再次手术发生率更高（=0.03），相邻节段退变（ASD）发生率更低（=0.04）。两组在神经功能缺损指数（NDI）评分（=0.36）、上肢视觉模拟评分（VAS ARM）（=0.73）、颈部视觉模拟评分（VAS NECK）（=0.63）、EQ-5D评分（=0.61）和吞咽困难发生率（0.18）方面无显著差异。
DCDA和ACDF在NDI评分、VAS评分、EQ-5D评分和吞咽困难方面结果相似。此外，DCDA可降低ASD风险，但会增加再次手术风险。
