The Meta-analysis Of Surgical Approach In Cervical Spondylotic Myelopathy

Objectivecervical spondylotic myelopathy is the most common and most serious type of cervical degenerative diseases, Because it causes serious decline in quality of life of patients and even life-threatening, surgical treatment should be actively taken. The surgical treatment obtains anterior cervical operation and posterior cervical operation, however, many academics always concern and dispute how to choose operation plan reasonably. At present, no direct evidence of evidence-based medicine has been showed that advantages and disadvantages of two kinds of operation approach.Methods and MaterialsIn this paper, we used the method of meta-analysis and the software of Revman 4.2, to analysis all the control studies which involving anterior operation and posterior operation of cervical spondylotic myelopathy and accorded with inclusive criteria. So that we could observe the effects of treatment outcome with average recovery rate and postoperative complication rate.ResultsA total of 8 related articles accorded with the inclusive criteria. The standardized mean difference(SMD) which is the combined effect of average recovery rate is 0.52 (0.36,0.69). Thus, the Chi-square value of Homogeneity test is 55.04 and p<0.00001.After eliminating the effect quantities of two studies which obviously deviated from invalid line, the result of sensitivity analysis is Q=0.60, p>0.05. The combined odds ratio(OR) of postoperative complication rate is 2.40(1.24,4.64). The Chi-square value of Homogeneity test is 11.20 and p>0.05. However, it has the possibility of reporting bias.ConclusionsBecause of the low quality of inclusive studies and possibility of reporting bias in the studies which include postoperative complication rate, we only considered that anterior operation has more trends to increase the average recovery rate than posterior operation. At the same time, the anterior operation has higher risk to increase postoperative complication rate than posterior operation.The anterior operation has more trends to increase the average recovery rate and higher risk to increase postoperative complication rate than posterior operation, which should be recommended for clinical application of evidence due to the evidence of moderate intensity. However, it is also need including more high-quality original research findings to support the result.