Cervical Anterior And Posterior Surgical Treatment Of Posterior Longitudinal Ligament Ossification Postoperative Symptoms And Complications Of Nerve Injury Risk Factors:a Meta-analysis

AIMS: To review the clinical manifestations and imaging data were confirmed as ossification of cervical posterior longitudinal ligament(OPLL)in patients with ? 2 segments.To evaluate the efficacy,safety,complications and related risk factors of anterior or posterior approach for the treatment of ossification of posterior longitudinal ligament of the cervical spine,and to provide some theoretical basis for clinical decision-making.METHOD: The computer searches the database: Pub Med,Web of science,EMBASE,CNKI,Wan-Fang and so on.The search time is limited to 1990 to November 2017.The related original research retrieved is evaluated according to inclusion and exclusion criteria.Eligible studies using REV-Man5.3 software Meta analysis.RESULT: 13 studies were included with total of 948 patients,meta-analysis showed that: The postoperative JOA score [MD = 0.65,95% CI 0.12 to 1.17,P = 0.02]?Neurological improvement rate [MD = 12.37,95% CI 5.22-19.52,P = 0.0007]?The operation time [MD = 65.30,95% CI 29.43 ~ 101.16,P = 0.0004]?Reoperation rate [OR = 8.55,95% CI 2.48-29.47,P = 0.0007]?All higher than the posterior group,the difference was significant.Anterior surgery group and posterior surgery group at preoperative JOA score [MD = 0.22,95% CI-0.06 to 0.49,P = 0.12]?intraoperative bleeding [MD =-3.59,95% CI-102.19 ~ 95.01,P = 0.94]?complications of surgery [OR = 1.03,95% CI 0.72-1.47,P = 0.87]?postoperative angle [MD = 3.86,95% CI-1.16 ~ 8.88,P = 0.13] no statistical difference.CONCLUSION: 1.The postoperative JOA score,neurological improvement rate in anterior surgical treatment group was better than the those in posterior surgical treatment group.2.Surgery time and and reoperation rate was lower in posterior surgical treatment group.3.There was no significant difference in the incidence of disease(Cerebrospinal fluid leakage?Recurrent laryngeal nerve injury?Axial pain?C5 nerve root palsy?Loosening of internal fixation?Hematoma pressure caused by neck pain)between the two groups in the concurrent rate.