Treating multi-level cervical disc disease with hybrid surgery compared to anterior cervical discectomy and fusion: a systematic review and meta-analysis
Purpose The traditional surgical approach to treat multi-level cervical disc disease (mCDD) has been anterior cervical discectomy and fusion (ACDF). There has been recent development of other surgical approaches to further improve clinical outcomes. Collectively, when elements of these different app...
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| Veröffentlicht in: | European spine journal 2017-02, Vol.26 (2), p.546-557 |
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| creator | Lu, Victor M. Zhang, Lucy Scherman, Daniel B. Rao, Prashanth J. Mobbs, Ralph J. Phan, Kevin |
| description | Purpose
The traditional surgical approach to treat multi-level cervical disc disease (mCDD) has been anterior cervical discectomy and fusion (ACDF). There has been recent development of other surgical approaches to further improve clinical outcomes. Collectively, when elements of these different approaches are combined in surgery, it is known as hybrid surgery (HS) which remains a novel treatment option. A systematic review and meta-analysis was conducted to compare the outcomes of HS versus ACDF for the treatment of mCDD.
Methods
Relevant articles were identified from six electronic databases from their inception to January 2016.
Results
From 8 relevant studies identified, 169 patients undergoing HS were compared with 193 ACDF procedures. Operative time was greater after HS by 42 min (
p
|
| doi_str_mv | 10.1007/s00586-016-4791-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1868302818</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4313376891</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-1d30729ca7ded5461188d2c78d01147d8f2b9bd22fe0a780d2b80eabb4eb4b783</originalsourceid><addsrcrecordid>eNqNkU1vFSEUhomxsdfqD3BjSNx0gx4YZgB3prFq0sRNu54wcKalmY8rMLeZn-K_ldtbjTYx6QYW53nfA3kIecPhPQdQHxJArRsGvGFSGc7WZ2TDZSUYmEo8JxswElijuDkmL1O6BeC1geYFORaqUUZWfEN-Xka0OUzXdFyGHNiAOxyow7gLzg7Uh-T2B9qE9C7kG3qzdjF4mpZ4jXGlbh63NqKneaZ2yhjDHP-No8vzuJahp_2Swjx9pJamNWUcy2JHI-4C3t3PR8yW2ckOawrpFTnq7ZDw9cN9Qq7OP1-efWUX3798O_t0wZyEOjPuK1DCOKs8-lo2nGvthVPaA-dSed2LznReiB7BKg1edBrQdp3ETnZKVyfk9NC7jfOPBVNux_2rh8FOOC-p5brRFQjNn4LWRlWyMqKg7x6ht_MSy9fuC5URTaNVofiBcnFOKWLfbmMYbVxbDu1ecXtQ3BbF7V5xu5bM24fmpRvR_0n8dloAcQBSGU3F0l-r_9v6C73JtNY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1867926687</pqid></control><display><type>article</type><title>Treating multi-level cervical disc disease with hybrid surgery compared to anterior cervical discectomy and fusion: a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Lu, Victor M. ; Zhang, Lucy ; Scherman, Daniel B. ; Rao, Prashanth J. ; Mobbs, Ralph J. ; Phan, Kevin</creator><creatorcontrib>Lu, Victor M. ; Zhang, Lucy ; Scherman, Daniel B. ; Rao, Prashanth J. ; Mobbs, Ralph J. ; Phan, Kevin</creatorcontrib><description>Purpose
The traditional surgical approach to treat multi-level cervical disc disease (mCDD) has been anterior cervical discectomy and fusion (ACDF). There has been recent development of other surgical approaches to further improve clinical outcomes. Collectively, when elements of these different approaches are combined in surgery, it is known as hybrid surgery (HS) which remains a novel treatment option. A systematic review and meta-analysis was conducted to compare the outcomes of HS versus ACDF for the treatment of mCDD.
Methods
Relevant articles were identified from six electronic databases from their inception to January 2016.
Results
From 8 relevant studies identified, 169 patients undergoing HS were compared with 193 ACDF procedures. Operative time was greater after HS by 42 min (
p
< 0.00001), with less intraoperative blood loss by 26 mL (
p
< 0.00001) and shorter return to work by 32 days (
p
< 0.00001). In terms of clinical outcomes, HS was associated with greater C2–C7 range of motion (ROM) preservation (
p
< 0.00001) and less functional impairment (
p
= 0.008) after surgery compared to ACDF. There was no significant difference between HS and ACDF with respect to postoperative pain (
p
= 0.12). The postoperative course following HS was not significantly different to ACDF in terms of length of stay (
p
= 0.24) and postoperative complication rates (
p
= 0.18).
Conclusions
HS is a novel surgical approach to treat mCDD, associated with a greater operative time, less intraoperative blood loss and comparable if not superior clinical outcomes compared to ACDF. While it remains a viable consideration, there is a lack of robust clinical evidence in the literature. Future large prospective registries and randomised trials are warranted to validate the findings of this study.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-016-4791-y</identifier><identifier>PMID: 27679431</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Blood Loss, Surgical ; Cervical Vertebrae - surgery ; Diskectomy ; Humans ; Intervertebral Disc Degeneration - surgery ; Intervertebral Disc Displacement - surgery ; Medicine ; Medicine & Public Health ; Neurosurgery ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Review Article ; Spinal Fusion ; Surgical Orthopedics</subject><ispartof>European spine journal, 2017-02, Vol.26 (2), p.546-557</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><rights>European Spine Journal is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-1d30729ca7ded5461188d2c78d01147d8f2b9bd22fe0a780d2b80eabb4eb4b783</citedby><cites>FETCH-LOGICAL-c405t-1d30729ca7ded5461188d2c78d01147d8f2b9bd22fe0a780d2b80eabb4eb4b783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00586-016-4791-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00586-016-4791-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>313,314,780,784,792,27921,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27679431$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lu, Victor M.</creatorcontrib><creatorcontrib>Zhang, Lucy</creatorcontrib><creatorcontrib>Scherman, Daniel B.</creatorcontrib><creatorcontrib>Rao, Prashanth J.</creatorcontrib><creatorcontrib>Mobbs, Ralph J.</creatorcontrib><creatorcontrib>Phan, Kevin</creatorcontrib><title>Treating multi-level cervical disc disease with hybrid surgery compared to anterior cervical discectomy and fusion: a systematic review and meta-analysis</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose
The traditional surgical approach to treat multi-level cervical disc disease (mCDD) has been anterior cervical discectomy and fusion (ACDF). There has been recent development of other surgical approaches to further improve clinical outcomes. Collectively, when elements of these different approaches are combined in surgery, it is known as hybrid surgery (HS) which remains a novel treatment option. A systematic review and meta-analysis was conducted to compare the outcomes of HS versus ACDF for the treatment of mCDD.
Methods
Relevant articles were identified from six electronic databases from their inception to January 2016.
Results
From 8 relevant studies identified, 169 patients undergoing HS were compared with 193 ACDF procedures. Operative time was greater after HS by 42 min (
p
< 0.00001), with less intraoperative blood loss by 26 mL (
p
< 0.00001) and shorter return to work by 32 days (
p
< 0.00001). In terms of clinical outcomes, HS was associated with greater C2–C7 range of motion (ROM) preservation (
p
< 0.00001) and less functional impairment (
p
= 0.008) after surgery compared to ACDF. There was no significant difference between HS and ACDF with respect to postoperative pain (
p
= 0.12). The postoperative course following HS was not significantly different to ACDF in terms of length of stay (
p
= 0.24) and postoperative complication rates (
p
= 0.18).
Conclusions
HS is a novel surgical approach to treat mCDD, associated with a greater operative time, less intraoperative blood loss and comparable if not superior clinical outcomes compared to ACDF. While it remains a viable consideration, there is a lack of robust clinical evidence in the literature. Future large prospective registries and randomised trials are warranted to validate the findings of this study.</description><subject>Blood Loss, Surgical</subject><subject>Cervical Vertebrae - surgery</subject><subject>Diskectomy</subject><subject>Humans</subject><subject>Intervertebral Disc Degeneration - surgery</subject><subject>Intervertebral Disc Displacement - surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosurgery</subject><subject>Operative Time</subject><subject>Pain, Postoperative</subject><subject>Postoperative Complications</subject><subject>Review Article</subject><subject>Spinal Fusion</subject><subject>Surgical Orthopedics</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU1vFSEUhomxsdfqD3BjSNx0gx4YZgB3prFq0sRNu54wcKalmY8rMLeZn-K_ldtbjTYx6QYW53nfA3kIecPhPQdQHxJArRsGvGFSGc7WZ2TDZSUYmEo8JxswElijuDkmL1O6BeC1geYFORaqUUZWfEN-Xka0OUzXdFyGHNiAOxyow7gLzg7Uh-T2B9qE9C7kG3qzdjF4mpZ4jXGlbh63NqKneaZ2yhjDHP-No8vzuJahp_2Swjx9pJamNWUcy2JHI-4C3t3PR8yW2ckOawrpFTnq7ZDw9cN9Qq7OP1-efWUX3798O_t0wZyEOjPuK1DCOKs8-lo2nGvthVPaA-dSed2LznReiB7BKg1edBrQdp3ETnZKVyfk9NC7jfOPBVNux_2rh8FOOC-p5brRFQjNn4LWRlWyMqKg7x6ht_MSy9fuC5URTaNVofiBcnFOKWLfbmMYbVxbDu1ecXtQ3BbF7V5xu5bM24fmpRvR_0n8dloAcQBSGU3F0l-r_9v6C73JtNY</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Lu, Victor M.</creator><creator>Zhang, Lucy</creator><creator>Scherman, Daniel B.</creator><creator>Rao, Prashanth J.</creator><creator>Mobbs, Ralph J.</creator><creator>Phan, Kevin</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170201</creationdate><title>Treating multi-level cervical disc disease with hybrid surgery compared to anterior cervical discectomy and fusion: a systematic review and meta-analysis</title><author>Lu, Victor M. ; Zhang, Lucy ; Scherman, Daniel B. ; Rao, Prashanth J. ; Mobbs, Ralph J. ; Phan, Kevin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-1d30729ca7ded5461188d2c78d01147d8f2b9bd22fe0a780d2b80eabb4eb4b783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Blood Loss, Surgical</topic><topic>Cervical Vertebrae - surgery</topic><topic>Diskectomy</topic><topic>Humans</topic><topic>Intervertebral Disc Degeneration - surgery</topic><topic>Intervertebral Disc Displacement - surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurosurgery</topic><topic>Operative Time</topic><topic>Pain, Postoperative</topic><topic>Postoperative Complications</topic><topic>Review Article</topic><topic>Spinal Fusion</topic><topic>Surgical Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lu, Victor M.</creatorcontrib><creatorcontrib>Zhang, Lucy</creatorcontrib><creatorcontrib>Scherman, Daniel B.</creatorcontrib><creatorcontrib>Rao, Prashanth J.</creatorcontrib><creatorcontrib>Mobbs, Ralph J.</creatorcontrib><creatorcontrib>Phan, Kevin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lu, Victor M.</au><au>Zhang, Lucy</au><au>Scherman, Daniel B.</au><au>Rao, Prashanth J.</au><au>Mobbs, Ralph J.</au><au>Phan, Kevin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treating multi-level cervical disc disease with hybrid surgery compared to anterior cervical discectomy and fusion: a systematic review and meta-analysis</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>26</volume><issue>2</issue><spage>546</spage><epage>557</epage><pages>546-557</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Purpose
The traditional surgical approach to treat multi-level cervical disc disease (mCDD) has been anterior cervical discectomy and fusion (ACDF). There has been recent development of other surgical approaches to further improve clinical outcomes. Collectively, when elements of these different approaches are combined in surgery, it is known as hybrid surgery (HS) which remains a novel treatment option. A systematic review and meta-analysis was conducted to compare the outcomes of HS versus ACDF for the treatment of mCDD.
Methods
Relevant articles were identified from six electronic databases from their inception to January 2016.
Results
From 8 relevant studies identified, 169 patients undergoing HS were compared with 193 ACDF procedures. Operative time was greater after HS by 42 min (
p
< 0.00001), with less intraoperative blood loss by 26 mL (
p
< 0.00001) and shorter return to work by 32 days (
p
< 0.00001). In terms of clinical outcomes, HS was associated with greater C2–C7 range of motion (ROM) preservation (
p
< 0.00001) and less functional impairment (
p
= 0.008) after surgery compared to ACDF. There was no significant difference between HS and ACDF with respect to postoperative pain (
p
= 0.12). The postoperative course following HS was not significantly different to ACDF in terms of length of stay (
p
= 0.24) and postoperative complication rates (
p
= 0.18).
Conclusions
HS is a novel surgical approach to treat mCDD, associated with a greater operative time, less intraoperative blood loss and comparable if not superior clinical outcomes compared to ACDF. While it remains a viable consideration, there is a lack of robust clinical evidence in the literature. Future large prospective registries and randomised trials are warranted to validate the findings of this study.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27679431</pmid><doi>10.1007/s00586-016-4791-y</doi><tpages>12</tpages></addata></record> |
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| ispartof | European spine journal, 2017-02, Vol.26 (2), p.546-557 |
| issn | 0940-6719 1432-0932 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Blood Loss, Surgical Cervical Vertebrae - surgery Diskectomy Humans Intervertebral Disc Degeneration - surgery Intervertebral Disc Displacement - surgery Medicine Medicine & Public Health Neurosurgery Operative Time Pain, Postoperative Postoperative Complications Review Article Spinal Fusion Surgical Orthopedics |
| title | Treating multi-level cervical disc disease with hybrid surgery compared to anterior cervical discectomy and fusion: a systematic review and meta-analysis |
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