No additional value of fusion techniques on anterior discectomy for neck pain: A systematic review
Evidence Based Medicine
Van Middelkoop M et al. – There is no additional benefit of fusion techniques applied within an anterior discectomy procedure on pain, recovery and return to work.Methods
- The primary search was conducted in MEDLINE, EMBASE, CINAHL, CENTRAL and PEDro up to June 2011.
- Only randomised, controlled trials of adults with neck pain that evaluated at least one clinically relevant primary outcome measure (pain, functional status, recovery) were included.
- Two authors independently assessed the risk of bias by using the criteria recommended by the CBRG and extracted the data.
- Data were pooled using a random effects model.
- The quality of the evidence was rated using the GRADE method.
- In total, 10 randomised, controlled trials were identified comparing additional fusion upon anterior decompression techniques, including 2 studies with a low risk of bias.
- Results revealed no clinically relevant differences in recovery: the pooled risk difference in the short–term follow–up was –0.06 (95% confidence interval –0.22 to 0.10) and –0.07 (95% confidence interval –0.14 to 0.00) in the long–term follow–up.
- Pooled risk differences for pain and return to work all demonstrated no differences.