Efficacy of Tracheal Traction Exercise for Prevention of Laryngopharyngeal Complications Following Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Tracheal traction exercise (TTE) has been proposed as a preventative measure for laryngopharyngeal complications following anterior cervical discectomy and fusion. However, the exact effects of TTE remain controversial. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy of TTE. We systematically searched PubMed, Web of Science, Embase, Cochrane, ClinicalTrials.gov, China National Knowledge Infrastructure, WANFANG DATA, VIP citation databases, and Chinese BioMedical Literature Database for randomized controlled trials (published between January 1, 2000, and January 23, 2023, without language restrictions) comparing the TTE group to the control group (non-TTE group). We assessed the risk of bias using Cochrane risk of bias assessment tool. Our primary end points were operation duration, the number of patients with postoperative dysphagia, and Visual Analog Scale (VAS) for laryngopharyngeal pain. We used a fixed-effects model to assess the pooled data. Of the 823 identified studies, 5 were eligible and included in our analysis (N= 542 participants). Compared with the control group, TTE reduced the incidence of postoperative dysphagia (relative risk= 0.41, 95% confidence interval [CI]: 0.28, 0.61, P<0.05) and operation duration (weighted mean difference=-10.24, 95% CI:-14.48,-6.00, P<0.05). However, no significant difference was observed in postoperative VAS between the 2 groups (weighted mean difference=-0.11, 95% CI:-0.23, 0.11, P=0.08 > 0.05). TTE can effectively reduce operation duration and postoperative dysphagia. However, it does not result in a significant difference in postoperative VAS.