Effects Of Domestic Anterior And Posterior Approach Operation On Cervical Spondylotic Myelopathy: A Systematic Review Of Randomized Evidence

Objective: To evaluate the effectiveness of anterior versus posterior surgical treatment of Cervical spondylotic myelopathy in our country.Methods: According to Cochrane systematic review methods, CNKI (1998 ~ 2009), CBM (1998 ~ 2009), VIP (1998 ~ 2009)were searched for randomized controlled trails or non- randomized controlled trails. Manually retrieve relevant Chinese Orthopaedics in order to avoid omissions, the quality of included studies, extract valid data。RevMan5.0 software was used for data analysis.Result: Seven articles including 572 patients of domestic Anterior and Posterior approach operation for Cervical spondylotic myelopathy were searched, among them, the Anterior group 337 patients and Posterior group 235.The improvement rate of Anterior and Posterior approach operation for Cervical spondylotic myelopathy was compared by Homogeneity test with Meta-analysis. The results showed:[RR=1.21, 95%CI(0.84,1.72)], The results improved rate of the two operation methods was not significant.Conclusion: The improvement rate between Anterior approach operation and Posterior approach operation on Cervical spondylotic myelopathy was not significant. In this systematic review, there may be High probability of selective bias, performance bias, measurement bias and publication bias because of C-level included articles in RCT and only Chinese literatures. There is no full evidence of improvement rate between Anterior approach operation and Posterior approach operation on Cervical spondylotic myelopathy is the same. It only can be a reference for clinical treatment. Our conclusions need further validation by large sample, multi-center, methodological quality of randomized controlled trials standard further authentication.