Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of multilevel cervical spondylotic myelopathy: systematic review and a meta-analysis

Figures & data

Figure 1 Flow chart of study selection.

Table 1 Demographic data from studies included in meta-analysis

Study	Surgeries	Patients, n (ACDF/ACCF)	Country	Year of publication
Li et al^Citation7	ACDF/ACCF	89 (47/42)	People’s Republic of China	2013
Lin et al^Citation11	ACDF/ACCF	120 (57/63)	People’s Republic of China	2012
Liu et al^Citation8	ACDF/ACCF	108 (69/39)	People’s Republic of China	2012
Song et al^Citation10	ACDF/ACCF	40 (25/15)	South Korea	2012
Guo et al^Citation58	ACDF/ACCF	67 (43/24)	People’s Republic of China	2011
Lian et al^Citation59	ACDF/ACCF	105 (55/50)	People’s Republic of China	2010
Oh et al^Citation49	ACDF/ACCF	31 (14/17)	South Korea	2009
Uribe et al^Citation60	ACDF/ACCF	80 (42/38)	USA	2009
Hwang et al^Citation41	ACDF/ACCF	62 (27/35)	People’s Republic of China	2007
Liu et al^Citation61	ACDF/ACCF	52 (19/33)	People’s Republic of China	2006
Nirala et al^Citation62	ACDF/ACCF	201 (69/132)	India	2004
Hilibrand et al^Citation40	ACDF/ACCF	190 (131/59)	USA	2002
Wang et al^Citation63	ACDF/ACCF	52 (32/20)	USA	2001
Emery et al^Citation64	ACDF/ACCF	100 (45/55)	USA	1998
Yonenobu et al^Citation65	ACDF/ACCF	71 (50/21)	Japan	1985

Abbreviations: ACCF, anterior cervical corpectomy and fusion; ACDF, anterior cervical discectomy and fusion.

Figure 2 Comparison of operation time between ACDF and ACCF for the treatment of CSM.

Abbreviations: ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; CSM, cervical spondylotic myelopathy; CI, confidence interval; SD, standard deviation; IV, independent variable.

Figure 3 Comparison of blood loss between ACDF and ACCF for the treatment of CSM.

Abbreviations: ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; CSM, cervical spondylotic myelopathy; CI, confidence interval; SD, standard deviation; IV, independent variable.

Figure 4 Comparison of bone fusion failure between ACDF and ACCF for the treatment of CSM.

Abbreviations: ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; CSM, cervical spondylotic myelopathy; CI, confidence interval; M–H, Mantel–Haenszel test.

Figure 5 Comparison of numbers of complications between ACDF and ACCF for the treatment of CSM.

Abbreviations: ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; CSM, cervical spondylotic myelopathy; CI, confidence interval; M–H, Mantel–Haenszel test.

Figure 6 Comparison of post Japanese Orthopedic Association scores between ACDF and ACCF for the treatment of CSM.

Abbreviations: ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; CSM, cervical spondylotic myelopathy; IV, independent variable; CI, confidence interval; SD, standard deviation.

Figure 7 (A) Comparison of recovery rates between ACDF and ACCF for the treatment of CSM. (B) Comparison of visual analog scale scores between ACDF and ACCF for the treatment of CSM.

Abbreviations: ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; CSM, cervical spondylotic myelopathy; IV, independent variable; CI, confidence interval; SD, standard deviation.

Figure 8 The funnel plots are largely symmetrical, suggesting there is no publication bias in the meta-analysis of anterior cervical discectomy and fusion and anterior cervical corpectomy and fusion in the treatment of cervical spondylotic myelopathy.

Notes: The funnel plot from seven studies comparing operation time (A). The funnel plot from seven studies comparing blood loss (B). The funnel plot from 14 studies comparing bone fusion failure (C). The funnel plot from ten studies comparing complications (D). The funnel plot from nine studies comparing post Japanese Orthopedic Association scores (E). The funnel plot from five studies comparing the recovery rates (F). The funnel plot from four studies comparing the visual analog scale scores (G).
Abbreviations: SE, standard error; MD, mean difference.

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