OBJECTIVE: The aim of this study is to analyze the complications related to multilevel anterior cervical discectomy and fusion (ACDF) using osteobiologics other than bone morphogenetic protein (BMP).
METHODS: A systematic review of the literature was conducted using PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases. The search to identify studies reporting complications in multilevel ACDF surgery using osteobiologics other than bone morphogenetic protein was performed in August 2020. The study was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).
RESULTS: A total of 584 articles were found after searching the databases and removing duplicates. Next, screening was performed in a double reviewer process, and 153 eligible articles-with 4 retrospective studies-in full-text were selected; these met all inclusion criteria. A total of 197 patients received 3-level ACDF, while 72 patients received 4-level ACDF. Osteobiologics were used in all selected articles, allograft was used in 4 studies, autologous bone graft was utilized in 3 articles, and hydroxyapatite was used in 1 article. The main complications reported were dysphagia, adjacent segment disease, and pseudarthrosis.
CONCLUSIONS: Given the limited evidence, no conclusions on complications in multilevel ACDF using osteobiologics other than BMP could be made. However, descriptively, the most common complications found were dysphagia, adjacent segment disease, and pseudoarthrosis. Further prospective studies separately analyzing complications in multilevel ACDF by osteobiologics and a number of treated levels are needed.
目的:本研究的目的是分析使用骨形态发生蛋白(BMP)以外的骨生物学药物与多节段颈前路椎间盘切除术和融合术(ACDF)相关的并发症。
方法:使用PubMed对文献进行了系统回顾,EMBASE,科克伦图书馆,和ClinicalTrials.gov数据库。在2020年8月进行了搜索,以确定报告使用骨形态发生蛋白以外的骨生物学的多级ACDF手术并发症的研究。根据系统评价和荟萃分析(PRISMA)的首选报告项目报告研究。
结果:在搜索数据库并删除重复项后,共发现584篇文章。接下来,筛选是在双重审查过程中进行的,共选择了153篇符合条件的文章-4篇回顾性研究-全文;这些文章符合所有纳入标准.共有197名患者接受了3级ACDF,72例患者接受4级ACDF。骨生物制剂用于所有选定的文章,在4项研究中使用了同种异体移植,在3篇文章中使用了自体骨移植,和羟基磷灰石用于1条。报告的主要并发症是吞咽困难,相邻节段病,和假关节.
结论:鉴于证据有限,对于使用骨生物制剂而非BMP的多水平ACDF的并发症,无法得出结论.然而,描述性的,最常见的并发症是吞咽困难,相邻节段病,和假关节炎。需要进一步的前瞻性研究,通过骨生物学和许多治疗水平分别分析多水平ACDF的并发症。