Single or double‐level anterior interbody fusion techniques for cervical degenerative disc disease
Información
- DOI:
- https://doi.org/10.1002/14651858.CD004958Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 18 octubre 2004see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Espalda y cuello
- Copyright:
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- Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Citado por:
Autores
Contributions of authors
Wilco Jacobs: Protocol, Search, Quality assessments, Data extraction, Report
Paul Willems: Protocol, Quality assessment, Data extraction, Draft review
Patricia Anderson: Third reviewer consultation, Draft review
Jacques van Limbeek: Consultant
Paul Pavlov: Clinical interpretation, Draft review
Sources of support
Internal sources
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Sint Maartenskliniek, Netherlands.
External sources
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No sources of support supplied
Declarations of interest
none
Acknowledgements
We would like to thank Dr Robert Schrijnemakers, librarian for his help in the literature search and the Cochrane Back Group for their help during the review process.
Version history
Published | Title | Stage | Authors | Version |
2011 Jan 19 | Single or double‐level anterior interbody fusion techniques for cervical degenerative disc disease | Review | Wilco Jacobs, Paul C Willems, Jacques van Limbeek, Ronald Bartels, Paul Pavlov, Patricia G Anderson, F Cumhur Oner | |
2004 Oct 18 | Single or double‐level anterior interbody fusion techniques for cervical degenerative disc disease | Review | Wilco Jacobs, Patricia G Anderson, Jacques van Limbeek, Paul C Willems, Paul Pavlov, Ronald Bartels | |
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Humans;
Study | Group | Excellent | Good | Satisfied | poor |
Abd‐Alrahman 1999 | Discectomy | 24 | 12 | 2 | 2 |
Abd‐Alrahman 1999 | Fusion | 20 | 20 | 7 | 3 |
Study | Group | Excellent | Good | Fair | Poor |
Martins 1976 | Discectomy | 8 | 15 | 2 | 1 |
Martins 1976 | Fusion | 21 | 3 | 1 | 0 |
Term | Definition |
Spondylosis | Degenerative disease of the spine associated with degeneration of the intervertebral discs and osteophytes |
Radiculopathy | Symptoms arising from compression of the nerve roots |
Myelopathy | Symptoms arising from compression of the spinal cord |
Herniated disc | Bulging of the intervertebral disc, often causing pressure on the nerve roots |
Spondylotic myelopathy | Dysfunction of the spinal cord due to direct compression by for example stenosis, herniation or osteophytes. |
Autograft | Implant material derived from the same individual |
Allograft | Implant material from any other source than the same individual |
Dimension | Search strings |
Diagnosis | Cervical(TW) |
Treatment | Fusion(TW) |
Study design | Randomised Controlled Trial(PT) |
Criteria for a judgment of yes for the sources of risk of bias | |
Randomisation | Was the method of randomization adequate? |
Allocation concealment | Wat the treatment allocation concealed? |
Patient blinding | Is the patient blinded for the treatment allocation? |
Surgeon blinding | Is the surgeon blinded for the treatment allocation? |
Outcome assessor blinding | Is the outcome assessor blinded for the treatment allocation? |
Drop‐out | Is the drop‐out rate given and acceptable? |
Intention to treat | Is an intention to treat analysis given? |
Prognostic factors | Are the patient groups comparable on prognostic factors? |
Co‐interventions | Are the co‐interventions described in sufficient detail? |
Compliance | Is the compliance acceptable? |
Timing | Is the timing of the outcome assessments comparable between groups and consistent within groups? |
Criteria | Description | |
External validity | Parameter choice | Is the outcome parameter relevant? At least 'pain' should be scored to receive a '+'. If no pain, but another functional or clinical measure was used, a +/‐ was given. |
Selection criteria | Are the selection criteria given? | |
Treatment | Is the treatment described in sufficient detail? | |
Adverse effect | Are the adverse effects described? | |
Short‐term follow‐up | Is a short‐term follow‐up assessment used? | |
Long‐term follow‐up | Is a long‐term follow‐up assessment used? | |
Statistical analyses | Group sizes | Are the group sizes and subgroup sizes given? |
Point estimates | Are point estimates given for all relevant outcome parameters? | |
Variabilty or individual data | Is a usable indicator of variability given for all point estimates? | |
Statistical analyses | Are the statistical analyses used described? | |
Statistical analyses valid | Are the statistical analyses used valid? |
Study | Selection criteria | Description methods | Adverse effects | Short‐term follow‐up | Long‐term follow‐up |
Abd‐alrahman | + | + | + | + | ‐ |
Dowd | +/‐ | +/‐ | + | + | +/‐ |
Martins | +/‐ | +/‐ | + | + | ‐ |
Rosenorn | + | + | + | + | ‐ |
van den Bent | + | + | + | + | ‐ |
Lofgren | +/‐ | + | + | + | ‐ |
Madawi | + | + | + | + | ‐ |
Baskin | + | + | ‐ | + | ‐ |
McConnel | ‐ | + | + | + | ‐ |
Hacker | + | + | + | + | ‐ |
Savolainen | + | + | + | + | ‐ |
Vavruch/ Peolsson | + | + | + | + | ‐ |
Zoega | ‐ | ‐ | + | + | ‐ |
McGuire | + | + | ‐ | + | ‐ |
Study | Group sizes | Point estimates | Descr of variability | Statistics described | Statistics valid | General remarks |
Abd‐alrahman | + | ‐ | ‐ | + | +/‐ | The randomisation technique is not described. The description of in‐ and exclusion criteria is sufficient. The results are not split for one or two level procedures. Results for arm and neck pain with VAS scores are not presented. |
Dowd | ‐ | ‐ | ‐ | ‐ | ? | The randomisation technique is valid and the allocation is concealed. The results were not split for one or two level procedures and exclusion criteria are not mentioned. The percentage lost to follow‐up at 4.5 years is larger than 20%. The study found a shorter hospital stay, but a lower fusion rate and no difference in patient satisfaction for the discectomy group. |
Martins | +/‐ | ‐ | ‐ | + | ‐ | The randomisation technique is not described (lottery style) and it is not clear whether patients form a homogeneous group. Data presentation is lacking detail. |
Rosenorn | + | + | na | + | + | The randomisation technique is not described. It is unclear whether groups are comparable on diagnosis and, consequently, it is unclear whether the groups are homogeneous. Data presentation is sufficient. |
van den Bent | +/‐ | ‐ | ‐ | + | ‐ | Randomisation method is valid and allocation is concealed. One and two‐level procedures were mixed. Results are presented in bars with no information of values. |
Lofgren | + | ‐ | ‐ | + | + | A good description of the randomisation with allocation concealment, but did not discriminate between clinical indication of radiculopathy and myelopathy, had high lost to follow‐up for the RSA measurements and did not describe their in and exclusion criteria sufficiently. |
Madawi | + | ‐ | ‐ | + | + | The randomisation technique is not described. Madawi et al. did not discriminate between one or two level surgeries and the timing of the follow‐up is questionable. |
Baskin | + | + | ‐ | ‐ | ? | The randomisation technique is not described, results of One and two‐level surgeries were combined, and there is considerable lost to follow‐up at 12 and 24 months. |
McConnel | + | ‐ | ‐ | ‐ | + | The randomization technique used sealed envelopes. In‐ and exclusion criteria are not mentioned, drop out percentage is moderate and point estimates and variability are not given. There is a range of indications and one and two‐level procedures were included. |
Hacker | + | ‐ | ‐ | + | + | Randomisation procedure is not clear, results are not split for one and two level procedures and point estimates of pain with SD are not given. Authors did not find a difference, except for reduced donor site pain for the cage group. |
Savolainen | + | +/‐ | na | + | ‐ | The randomisation technique is not clear. |
Vavruch/ Peolsson | + | + | ‐ | + | + | The randomisation technique is adequate with allocation concealment. This study included two and three level surgeries, but separate results are not given. Also, no measures of variability are given. |
Zoega | + | + | +/‐ | + | + | The randomisation technique is valid with allocation concealment. In‐ and exclusion criteria are not explicitly specified, the acquired group characteristics are described. Ranges are given instead of standard deviations. |
McGuire | ‐ | ‐ | ‐ | + | ‐ | The randomisation technique is not described which makes the study suspicious because of the unequal group sizes. Pain is mentioned as being significantly different between the groups, but data is not given. |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
1 Hospital stay Show forest plot | 2 | 174 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.86 [‐1.57, ‐0.15] |
2 Operation time Show forest plot | 2 | 174 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.92 [‐1.24, ‐0.61] |
3 Odom Show forest plot | Other data | No numeric data | ||
4 No Fusion Show forest plot | 2 | 136 | Risk Ratio (M‐H, Random, 95% CI) | 0.53 [0.02, 11.93] |
5 Pain not relieved at 5 weeks Show forest plot | 2 | 165 | Risk Ratio (M‐H, Random, 95% CI) | 0.45 [0.25, 0.81] |
6 Not Returned to work at 5 weeks Show forest plot | 2 | 144 | Risk Ratio (M‐H, Random, 95% CI) | 1.26 [1.02, 1.54] |
7 Not Returned to work at 10 weeks Show forest plot | 2 | 128 | Risk Ratio (M‐H, Random, 95% CI) | 1.44 [0.77, 2.69] |
8 Alignment Show forest plot | Other data | No numeric data | ||
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
1 Total pain Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 16.0 [2.31, 29.69] |
2 Arm pain Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 32.0 [17.30, 46.70] |
3 Neck pain Show forest plot | 1 | 27 | Std. Mean Difference (IV, Random, 95% CI) | 0.95 [0.15, 1.75] |
4 headache Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 18.0 [4.77, 31.23] |
5 Sensory function Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 15.0 [2.07, 27.93] |
6 Muscle power Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 27.0 [11.48, 42.52] |
7 Odoms criteria Show forest plot | 1 | 115 | Risk Ratio (M‐H, Random, 95% CI) | 0.94 [0.77, 1.15] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
1 Total pain Show forest plot | 1 | 28 | Mean Difference (IV, Random, 95% CI) | 12.0 [‐3.74, 27.74] |
2 Arm pain Show forest plot | 1 | 28 | Mean Difference (IV, Random, 95% CI) | 4.0 [‐13.05, 21.05] |
3 Neck pain Show forest plot | 1 | 28 | Mean Difference (IV, Random, 95% CI) | 10.0 [‐6.70, 26.70] |
4 Headache Show forest plot | 1 | 28 | Mean Difference (IV, Random, 95% CI) | 6.0 [‐9.93, 21.93] |
5 Sensory function Show forest plot | 1 | 28 | Mean Difference (IV, Random, 95% CI) | 22.0 [6.07, 37.93] |
6 Muscle power Show forest plot | 1 | 28 | Mean Difference (IV, Random, 95% CI) | 6.0 [‐11.22, 23.22] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
1 Total pain Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 28.0 [14.10, 41.90] |
2 Arm pain Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 36.0 [22.19, 49.81] |
3 Neck pain Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 28.0 [13.02, 42.98] |
4 Headache Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 24.0 [7.35, 40.65] |
5 Sensory function Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 37.0 [23.62, 50.38] |
6 Muscle power Show forest plot | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 33.0 [17.28, 48.72] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
1 No Fusion Show forest plot | 2 | 143 | Risk Ratio (M‐H, Random, 95% CI) | 2.37 [1.10, 5.13] |
1.1 One and two‐levels | 2 | 143 | Risk Ratio (M‐H, Random, 95% CI) | 2.37 [1.10, 5.13] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
1 No Fusion Show forest plot | 1 | 46 | Risk Ratio (M‐H, Random, 95% CI) | 0.0 [0.0, 0.0] |
1.1 One level | 1 | 46 | Risk Ratio (M‐H, Random, 95% CI) | 0.0 [0.0, 0.0] |