医学
颈椎前路椎间盘切除融合术
荟萃分析
并发症
髂嵴
外科
科克伦图书馆
融合
脊柱融合术
系统回顾
随机对照试验
梅德林
内科学
颈椎
法学
哲学
语言学
政治学
作者
Hongyu Meng,Tianyu Jin,J Wang,Xiangtian Ji,Zhiyuan Peng,Maoyang Qi,Can Zhang,Wanru Duan,Zan Chen
标识
DOI:10.1016/j.wneu.2024.06.117
摘要
The optimal choice for fusion strategy in Anterior Cervical Discectomy and Fusion (ACDF) remains an unresolved issue. This study aims to perform a network meta-analysis and systematic review of fusion rate and complication rate of various fusion strategies used in ACDF. This study followed Prisma guidelines, and we searched PubMed, Embase, Cochrane Library, and Web of Science from inception to November 11, 2022, for RCTs comparing the efficacy and safety of fusion modalities in ACDF. The primary outcome was the fusion rate and complication rate. The PROSPERO number is CRD42022374440. This meta-analysis identified 26 RCT studies with 1789 patients across 15 fusion methods. The cage with autograft + plating (CATG + P) showed the highest fusion rate, surpassing other methods like iliac crest autograft (ICAG) and artificial bone graft (AFG). The stand-alone cage with autograft (SATG) had the second highest fusion rate. Regarding complication rate, the cage with artificial bone graft (CAFG) had the highest rate, more than other methods. The ICAG had a higher complication rate compared to ICAG + P, AFG, SAFG, SATG, and CALG. The SATG performed well in both fusion and complication rate. In this study, we conducted the first network meta-analysis to compare the efficacy and safety of various fusion methods in ACDF. Our findings suggest that SATG, with superior performance in fusion rate and complication rate, may be the optimal choice for ACDF. However, the results should be interpreted cautiously until additional research provides further evidence.
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