A Comparison Of Interbody Fusion Cage To Iliac Crest Autograft Without Plate In Anterior Cervical Discectomy And Fusion

Backgrounds:Cervical degenerative diseases can cause serious decline in quality of life of patients, even life-threatening. Surgical is a the basic treatment for cervical degenerative diseases. Cloward and Smith-Robinson procedure are both classic anterior cervical discectomy and fusion(ACDF) surgical approaches for cervical degenerative diseases. Also, different fusion materials, autodraft or cage placement, with same procedure have different outcomes. At present, there isn’t much direct evidence of evidence-based medicine has been showed that advantages and disadvantages of two kinds of operation approach.Methods:With a computer-based online search of2002-2012published and unpublished data on MedLine, BMJ, OVID, as well as WanFang database. Hand-reading 《Spine》,《Chinese journal of Orthopedics》journals. Evaluate by Meta-based analysis with by RevMan5.0software, including the following indexes: JOA scores, excellent and good rate, complication rate, fusion rate and donor site pain etc.Results:12studies involving870patients were included. The quality of included studies are high enough for analysis. The results of Meta-analysis indicated that cage team has advantages with statistically significant differences in excellent and good rate(OR=2.00,95%CI[1.18,3.39], P=0.01), fusion rate(OR=3.12,95%CI[1.38,7.08], P=0.006)and donor site pain(OR=0.05,95%CI[0.01,0.44],P=0.007). While no statistically significant differences in complication rate(OR=0.95,95%CI[0.52,1.71], P=0.85)Conclusion:Though both cage and autograft fusion in anterior cervical decompression and fusion surgery are effective for treating cervical degeneration diseases, and also has no differences in complication rate. Compared with autograft, cage has its advantages in post-surgery recovery and fusion rate, it helps great in reducing patients’ donor site pain.