PDF(Pubmed)
Abstract：
METHODS: Systematic review and meta-analysis.
OBJECTIVE: To compare clinical and radiographic outcomes as well as complications of unplated vs plated anterior cervical discectomy and fusion (ACDF) surgery considering the role of osteobiologics in single- and multi-level procedures.
METHODS: A systematic search of PubMed/MEDLINE, Scopus, CINAHL, EMBASE, CENTRAL, Cochrane and ClinicalTrials.gov databases was performed. Briefly, we sought to identify studies comparing unplated vs. plated ACDF for cervical degenerative disc disease reporting the use of osteobiologics in terms of clinical outcomes, radiographic fusion, and complications. Data on study population, follow-up time, type of cage and plate used, type of osteobiologic employed, number of levels treated, patient-reported outcomes (PROs), radiographic outcomes and complications were collected and compared. Relevant information was pooled for meta-analyses.
RESULTS: Thirty-eight studies met the inclusion criteria. No significant difference was found in terms of clinical outcomes between groups. Unplated ACDF was characterized by reduced blood loss, operation time and length of hospital stay. Fusion was achieved by the majority of patients in both groups, with no evidence of any specific contribution depending on the osteobiologics used. Dysphagia was more commonly associated with anterior plating, while cage subsidence prevailed in the unplated group.
CONCLUSIONS: Unplated and plated ACDF seem to provide similar outcomes irrespective of the osteobiologic used, with minor differences with doubtful clinical significance. However, the heterogeneity and high risk of bias affecting included studies markedly prevent significant conclusions.
OBJECTIVE: To compare clinical and radiographic outcomes as well as complications of unplated vs plated anterior cervical discectomy and fusion (ACDF) surgery considering the role of osteobiologics in single- and multi-level procedures.
METHODS: A systematic search of PubMed/MEDLINE, Scopus, CINAHL, EMBASE, CENTRAL, Cochrane and ClinicalTrials.gov databases was performed. Briefly, we sought to identify studies comparing unplated vs. plated ACDF for cervical degenerative disc disease reporting the use of osteobiologics in terms of clinical outcomes, radiographic fusion, and complications. Data on study population, follow-up time, type of cage and plate used, type of osteobiologic employed, number of levels treated, patient-reported outcomes (PROs), radiographic outcomes and complications were collected and compared. Relevant information was pooled for meta-analyses.
RESULTS: Thirty-eight studies met the inclusion criteria. No significant difference was found in terms of clinical outcomes between groups. Unplated ACDF was characterized by reduced blood loss, operation time and length of hospital stay. Fusion was achieved by the majority of patients in both groups, with no evidence of any specific contribution depending on the osteobiologics used. Dysphagia was more commonly associated with anterior plating, while cage subsidence prevailed in the unplated group.
CONCLUSIONS: Unplated and plated ACDF seem to provide similar outcomes irrespective of the osteobiologic used, with minor differences with doubtful clinical significance. However, the heterogeneity and high risk of bias affecting included studies markedly prevent significant conclusions.
摘要：
方法：系统评价和荟萃分析。
目的：考虑骨生物制剂在单级和多级手术中的作用，比较未铺板与铺板颈前路椎间盘切除术和融合术（ACDF）的临床和影像学结果以及并发症。
方法：对PubMed/MEDLINE的系统搜索，Scopus,CINAHL,EMBASE,中部,进行Cochrane和ClinicalTrials.gov数据库。简而言之，我们试图找出比较未电镀与针对颈椎间盘退行性疾病的电镀ACDF报告了在临床结果方面使用骨生物制剂，射线成像融合,和并发症。研究人群数据，随访时间,使用的保持架和板的类型，所使用的骨生物学类型，处理的级别数，患者报告结果（PRO），收集并比较影像学结果和并发症.汇集相关信息进行荟萃分析。
结果：38项研究符合纳入标准。两组之间的临床结果没有显着差异。未接种的ACDF的特点是失血减少，手术时间和住院时间。两组中的大多数患者都实现了融合，根据所使用的骨生物制剂，没有任何具体贡献的证据。吞咽困难通常与前钢板有关，而网箱沉降普遍存在于未镀层组。
结论：未电镀和电镀的ACDF似乎提供相似的结果，而与使用的骨生物学无关，差异不大，临床意义可疑。然而,异质性和高偏倚风险影响纳入的研究显著阻止了重要结论.
目的：考虑骨生物制剂在单级和多级手术中的作用，比较未铺板与铺板颈前路椎间盘切除术和融合术（ACDF）的临床和影像学结果以及并发症。
方法：对PubMed/MEDLINE的系统搜索，Scopus,CINAHL,EMBASE,中部,进行Cochrane和ClinicalTrials.gov数据库。简而言之，我们试图找出比较未电镀与针对颈椎间盘退行性疾病的电镀ACDF报告了在临床结果方面使用骨生物制剂，射线成像融合,和并发症。研究人群数据，随访时间,使用的保持架和板的类型，所使用的骨生物学类型，处理的级别数，患者报告结果（PRO），收集并比较影像学结果和并发症.汇集相关信息进行荟萃分析。
结果：38项研究符合纳入标准。两组之间的临床结果没有显着差异。未接种的ACDF的特点是失血减少，手术时间和住院时间。两组中的大多数患者都实现了融合，根据所使用的骨生物制剂，没有任何具体贡献的证据。吞咽困难通常与前钢板有关，而网箱沉降普遍存在于未镀层组。
结论：未电镀和电镀的ACDF似乎提供相似的结果，而与使用的骨生物学无关，差异不大，临床意义可疑。然而,异质性和高偏倚风险影响纳入的研究显著阻止了重要结论.
