Zero Profile Interbody Fusion With Traditional Titanium Plate Cage In The Treatment Of Degenerative Cervical Disease:a Meta Analysis

Objective: To investigate the efficacy of zero-notch interbody fusion cage and traditional titanium plate cage in the treatment of degenerative cervical spondylosis.Methods:Search the literatures of Pubmed,web of science,Medline,Cochrane library,etc.from the establishment of the database to October 2018,and collect all the clinical comparative literatures of zero-incision interbody fusion cage and traditional titanium plate Cage in the treatment of degenerative cervical spondylosis.The qualified articles were screened out,and two researchers independently used NOS quality assessment tools to evaluate the quality of the literature,extracted the literature data and entered the Revman 5.3 software meta-analysis.Results: A total of 14 articles were included in the literature,including 1011 subjects,including 481 in the Zero-P group and 530 in the traditional titanium plate Cage group.Meta-analysis results showed that the amount of intraoperative blood loss in the Zero-P group compared with the traditional titanium plate Cage group[ WMD=-4.55,95% CI(-6.87,-2.22),Z=3.83(P=0.0001)];JOA improvement rate[WMD=0.09,95% CI(-0.19,0.37),Z=0.64(P= 0.52)];NDI improvement rate[WMD=0.04,95% CI(-0.76,0.85),Z=0.11(P=0.91)];preoperative cervical Cobb angle [WMD=-0.06,95% CI(-1.67,1.54),Z=0.08(P=0.94)];There was no significant difference in postoperative cervical Cobb angle between the two groups[WMD=-0.44,95% CI(-1.47,0.59),Z=0.84(P=0.40)] Intervertebral fusion rate[OR=1.16,95% CI(-0.46,2.96),Z=0.32(P=0.75)];postoperative adjacent segment degeneration rate [OR=0.42,95% CI(0.23,2.78)Z=2.73(P=0.006)];degree of postoperative vertebral soft tissue swelling [OR=-0.89,95% CI(-1.40,-0.38)Z=3.42(P=0.006)];early postoperative dysphagia The rate of Zero-P group was lower than that of the traditional Cage group,which was statistically different [OR=0.55,95%CI(0.41,0.74)Z=4.05(P?0.0001))];postoperative terminal follow-up dysphagia rate[OR = 0.16,95% CI(0.07,0.36)Z = 4.53(P?0.00001)].Conclusion: Zero-p group with conventional Cage JOA was no improvement inthe rate of improvement of the NDI,cervical Cobb angle interbody fusion rates and two significant difference occurs in the amount of reduction surgery,degeneration of adjacent segment,prevertebral The degree of soft tissue swelling and dysphagia during early and final follow-up were superior to the traditional Cage group.