Comparison Of Effectivity And Safety Between Anterior Cervical Discectomy And Fusion Versus Anterior Cervical Corpectomy And Fusion For Adjacent Two-level Cervial Spondylotic Myelopathy:A Meta-analysis

Objective:Cervical spondylotic myelopathy is the most harmful type of cervical spondylosis,which causes serious social and economic burdens.Among them,the most common is adjacent two-level cervical spondylotic myelopathy.ACDF and ACCF are two commonly used surgical methods for the treatment of adjacent two-level cervical spondylotic myelopathy.However,the choice of two surgical methods is still controversial in clinical practice.This study uses a meta-analysis method to systematically evaluate the effectiveness and safety of two-level ACDF and one-level ACCF in the treatment of adjacent two-level cervical spondylotic myelopathy.Methods:Computer search of Cochrane Library,Pubmed(Medline),CNKI、VIP、Wanfang database,from January 2000 to January 2020,Randomized or non-randomized controlled trials comparing two-level ACDF and one-level ACCF in the treatment of adjacent two-level cervical spondylotic myelopathy.After the literatures meeting the inclusion criteria were included,the data in the literatures were extracted and Meta analysis was performed using Revman5.3 software.Results:In this study,13 Chinese and 9 English literatures were included,and1361 patients were included.The result of this meta-analysis showde that two-level ACDF is superior to one-level ACCF in the length hospital stay,blood loss,operation time,the angle of C2 to C7 and T1-slope.However,there was no significant difference of Neck and Arm VAS,JOA scores,total complications,C2-7SVA and fusion rate.Conclusions:Both two-level ACDF and one-level ACCF can achieve good clinical outcomes,but two-level ACDF has less intraoperative blood loss,surgery time,and hospital stay,and cervical sagittal balance was better in the two-levelACDF.