Abstract
RetractedThe purpose — to compare the effectiveness of Discover cervical disk arthroplasty (CDA) and anterior cervical discectomy with fusion (ACDF) in the surgical treatment of cervical intervertebral disk (IVD) degenerative disease.Study design — a meta-analysis of randomized clinical trials.Material and Methods. Randomized clinical trials were conducted in the Pubmed, EMBASE, ELibrary and Cochrane Library databases published from 2008 to October 2018, which compared the results of Discover CDA and ACDF techniques in the surgical treatment of cervical IVD degenerative disease. For dichotomous variables, the relative risk and 95% confidence interval were calculated, standardized difference of mean values and their 95% confidence interval were used for continuous variables using the random effects model.Results. This meta-analysis included 9 randomized controlled clinical trials, including the results of surgical treatment of 513 patients with degenerative disease of the cervical IVD. In the CDA group, the operation time was significantly shorter, in contrast to the group of patients who underwent ACDF (p0.0001). The values of blood loss (p = 0.89), levels of quality of life for patients according to the Neck Disability Index (NDI) (p = 0.22), severity of pain in the cervical spine (p = 0.50) and upper limbs on a visual analogue scale (VAS) (p = 0.16), as well as the prevalence of secondary surgical procedures (p = 0.68) and adverse events (p = 0.40) between the compared groups did not have significant differences. At the same time, significantly large values of the range of motion at the operated level were noted in the CDA group (p0.00001).Conclusion. Discover CDA in comparison with ACDF has a significantly large values of range of motion at the operated level. At the same time, there were no statistically significant differences in the NDI scores, VAS pain scores in cervical spine and upper limbs, and the prevalence of secondary surgical procedures and adverse events between the compared groups of respondents were not identified.
Highlights
С дегенерацией шейных межпозвонковых дисков (МПД) [1, 2]
В значениях выраженности болевого синдрома по ВАШ в верхних конечностях между группами также не отмечено статистически значимых различий (СРС = -0,47, 95% доверительный интервал (ДИ): -1,12, 0,18, р = 0,16; I2 = 87%)
Shepelev — doctoral student, Irkutsk State Medical Academy of Continuing Education, Irkutsk, Russian Federation травматология и ортопедия россии / Traumatology and orthopedics of Russia
Summary
Операция переднего шейного спондилоде- распространена во многих нейрохирургических за (ПШС) представляет собой «золотой стандарт» клиниках мира [5]. Восочетаний «Discover cervical disk arthroplasty», Дизайн исследования — метаанализ рандоми- «Discover cervical total disk replacement», «anterior зированных клинических исследований, в кото- cervical diskectomy and fusion», «cervical spine рых сравниваются методики тотальной артропла- degeneration», «cervical intervertebral disk degeстики (ТА) протезом Discover и переднего шейного neration» в англоязычных системах; «тотальная спондилодеза (ПШС) при хирургическом лечении артропластика шейных межпозвонковых дисдегенеративного заболевания шейных межпоз- ков протезом Discover», «тотальное эндопровонковых дисков (МПД). Материал и методы Стратегия поиска и отбора литературных источников d Выполнен поиск рандомизированных клинических исследований в базах данных PubMed, te EMBASE, eLibrary и Cochrane Library, опубликованных в период с 2008 по октябрь 2018 г., в которых сравниваются результаты применения методик ТА протезом Discover и ПШС в хирургическом лечении тезирование шейных межпозвонковых дисков протезом Discover», «передний шейный спондилодез», «дегенерация шейного отдела позвоночника», «дегенеративное заболевание шейных межпозвонковых дисков» — в системе eLibrary.
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