A Systematic Review on Neurological Outcomes for Cervical Degenerative Myelopathy After Anterior Decompression Surgery: Motion Preservation vs Fusion

Valérie N.E. Schuermans; Anouk Y.J.M. Smeets; Lauren G.C. van de Kar; Sem M.M. Hermans; Inez Curfs; Toon F.M. Boselie; Henk van Santbrink

doi:10.14444/8320

Article Figures & Data

Figures

Tables
Supplementary Materials

Download figure
Open in new tab
Download powerpoint
Figure
Preferred reporting items for systematic reviews and meta-analyses flowchart of inclusion process.

View popup

Table 1

Results of included studies.

Author (Year)	Study Time Span, y	Intervention	Age, y, Mean (±SD or range)	Levels Operated	N	Preoperative Score, Mean (±SD)	Postoperative Score, Mean (±SD)	Utility Measurement Tool
Comparative studies
Chen et al (2019)	3	ACDF	46.8 (±6.0)	1 level	30	7.49 (±2.39)	14.59 (±1.22)	JOA
Chen et al (2019)	3	ACDA	48.5 (±4.6)	1 level	30	7.38 (±2.41)	15.42 (±0.46)	JOA
Cheng et al (2011)	3	ACDF	47.7 (±5.8)	1 level (n = 21)	42	9.00 (±1.20)	14.80 (±1.20)	JOA
				2 level (n = 17)
				3 level (n = 4)
		ACDA	47.2 (±5.7)	1 level (n = 24)	41	9.00 (±1.20)	15.20 (±1.20)
				2 levels (n = 14)
				3 levels (n = 3)
Sun et al (2020)	1	Normal ACDF	52.4 (±10.1)	1 level	31	8.90 (±1.40)	13.60 (±1.50)	JOA
Sun et al (2020)	1	Distraction ACDF	51.6 (±8.9)	1 level	30	8.80 (±1.50)	13.30 (±1.50)	JOA
Sorar et al (2007)	2.7	ACDF	53	1 level (n = 5)	14	12.80 (±0.50)	15.60 (±0.40)	mJOA
		ACDF	53	2 levels (n = 9)	14
		Corpectomy	59.3	2 levels (n = 2)	6
		Corpectomy	59.3	3 levels (n = 4)	6
Pescatori et al (2020)	3	Corpectomy (mild/moderate CDM)	57.4 (±10.6)	1 level (n = 22)	30	13.23 (-)	16.00 (-)	mJOA
		Corpectomy (mild/moderate CDM)		2 levels (n = 25)	30	13.23 (-)	16.00 (-)
		Corpectomy (severe CDM)		3 levels (n = 13)	30	7.26 (-)	12.66 (-)
Cohort studies
Li et al (2019)	1	Anterior (anterior cervical discectomy + ACDF + corpectomy)	50 (±8.55)	1 level (n = 54)	117	11.47 (±1.27)	14.67 (±1.27)	JOA1
			54.0 (±8.77)	2 levels (n = 45)
			57.7 (±9.14)	3 levels (n = 18)
Pandita et al (2018)	1	ACDF	51.0 (±9.38)	1 level (n = 23)	30	12.40 (±3.68)	14.92 (±3.24)	mJOA, Nurick
Pandita et al (2018)	1	ACDF	51.0 (±9.38)	2 levels (n = 7)	30	12.40 (±3.68)	14.92 (±3.24)	mJOA, Nurick
Zika et al (2020)	5	ACDF	50.8 (39–70)	1 level (n = 9)	36	10.80 (±1.90)	15.50 (±3.00)	mJOA
				2 levels (n = 17)
				3 levels (n = 8)
				4 levels (n = 2)
Zhang et al (2020)	5	ACDF	54.9 (±9.62)	-	35	11.98 (±2.21)	16.54 (±1.07)	mJOA
Pehlivanoglu et al (2019)	2	ACDA	52.4 (37–69)	1 level (n = 15)	18	11.30 (±0.30)	16.60 (±0.10)	JOA
Pehlivanoglu et al (2019)	2	ACDA	52.4 (37–69)	2 levels (n = 3)	18	11.30 (±0.30)	16.60 (±0.10)	JOA
Tian et al (2010)	3.49 (mean)	ACDA	50.9 (29–73)	1 level (n = 39)	50	14.00 (-)	16.50 (-)	JOA
Tian et al (2010)	3.49 (mean)	ACDA	50.9 (29–73)	2 levels (n = 11)	50	14.00 (-)	16.50 (-)	JOA

ACDA, anterior cervical discectomy with arthroplasty; ACDF, anterior cervical discectomy and fusion; CDM, cervical degenerative myelopathy; JOA, Japanese Orthopedic Association score; mJOA, modified Japanese Orthopedic Association score.

View popup

Table 2

Secondary outcomes.

Author (Year)	Intervention	Visual Analog Scale Score, Mean (±SD)		Neck Disability Index Score, Mean (±SD)		Odom Criteria, %
Author (Year)	Intervention	Preoperative	Postoperative	Preoperative	Postoperative	Excellent	Good	Fair	Poor
Comparative studies
Chen et al (2019)	ACDF	7.33 (±1.61)	1.31 (±0.37)	37.47 (±6.86)	6.89 (±2.53)	97.4 (Excellent or good)		-	-
Chen et al (2019)	ACDA	7.54 (±1.44)	1.29 (±0.41)	38.63 (±5.77)	7.11 (±3.73)	96.7 (Excellent or good)		-	-
Cheng et al (2011)	ACDF	NA		50.10 (±5.80)	6.96 (-)	95 (Excellent, good, or fair)			-
Cheng et al (2011)	ACDA	NA		50.60 (±6.00)	1.74 (-)	100 (Excellent, good, or fair)			-
Sun et al (2020)	Normal ACDF	1.39 (-)	1.51 (-)	NA		NA
Sun et al (2020)	Distraction ACDF	1.51 (-)	1.17 (-)	NA		NA
Cohort studies
Li et al (2019)	Anterior (anterior cervical discectomy + ACDF + corpectomy)	NA		NA		NA
Pandita et al (2018)	ACDF	NA		NA		NA
Zika et al (2020)	ACDF	NA		NA		NA
Pescatori et al (2020)	Corpectomy (mild/moderate CDM)	NA		NA		NA
Pescatori et al (2020)	Corpectomy (severe CDM)	NA		NA		NA
Zhang et al (2020)	ACDF	5.67 (±1.63)	1.01 (±2.11)	9.67 (±2.66)	2.78 (±1.49)	NA
Pehlivanoglu et al (2019)	ACDA	Arm	Arm	36.70 (±1.40)	10.30 (±1.20)	NA
		5.70 (±0.50)	1.30 (±0.30)
		Neck	Neck
		6.10 (±0.70)	2.00 (±0.30)
Tian et al (2010)	ACDA	NA		-	11.20 (-)	54	44	2	0

ACDA, anterior cervical discectomy with arthroplasty; ACDF, anterior cervical discectomy and fusion; CDM, cervical degenerative myelopathy; JOA, Japanese Orthopedic Association score; mJOA, modified Japanese Orthopedic Association score; NA, not applicable.