Comparison of anterior and posterior approaches for functional improvement in cervical myelopathy: A systematic review and meta-analysis of 33,025 patients
ABSTRACT: Background: Cervical myelopathy is caused by pressure on the spinal cord in the neck, leading to pain, numbness, and balance issues. Surgery aims to decompress the spinal cord, with different approaches; anterior, posterior, or both depending on specifies. This systematic review and meta-...
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| Language: | English |
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Elsevier
2025-06-01
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| Series: | North American Spine Society Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666548424002609 |
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| author | Abdulsalam Aleid, MD Saud Aldanyowi, MD Hasan Alaidarous, MD Zainab Aleid, MD Abdulaziz Alharthi, MD Abbas Al Mutair, MD |
| author_facet | Abdulsalam Aleid, MD Saud Aldanyowi, MD Hasan Alaidarous, MD Zainab Aleid, MD Abdulaziz Alharthi, MD Abbas Al Mutair, MD |
| author_sort | Abdulsalam Aleid, MD |
| collection | DOAJ |
| description | ABSTRACT: Background: Cervical myelopathy is caused by pressure on the spinal cord in the neck, leading to pain, numbness, and balance issues. Surgery aims to decompress the spinal cord, with different approaches; anterior, posterior, or both depending on specifies. This systematic review and meta-analysis aimed to compare the risks and benefits of anterior and posterior surgical techniques. Methods: Adhering to the PRISMA guidelines, we conducted a systematic search across the databases including PubMed, Scopus, and Web of Science for studies comparing anterior and posterior surgical approaches for cervical myelopathy. Studies that met our predefined inclusion criteria were selected by 2 independent reviewers. The methodological quality of the selected studies was assessed using NOS and Rob-2 tools and analysis was done using the Review Manager tool. One RCT and 22 cohort studies including 33,025 patients were included in the analysis. Results: The anterior approach was associated with better neurological recovery and a greater improvement in Cobb's angle with MD of 4.18 (95%CI: 0.38, 7.91, p=.03), and 6.91 (95%CI: 1.85, 11.97, p=.007), respectively. The anterior approach showed a statistically significant decrease in VAS, and NDI scales with MD of −0.44 (95%CI: −0.75, −0.12, p=.007), and −1.91 (95%CI: −3.74, −0.09, p=.04), respectively as compared to posterior approach. Conclusions: Studies suggest that an anterior approach for cervical myelopathy may improve nerve function, correct spinal curvature more effectively, and lead to fewer complications, less pain, reduced blood loss, and a shorter hospital stay compared to a posterior approach. |
| format | Article |
| id | doaj-art-307189e27ee54e14a41405d3972fba7b |
| institution | Kabale University |
| issn | 2666-5484 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | North American Spine Society Journal |
| spelling | doaj-art-307189e27ee54e14a41405d3972fba7b2025-08-20T03:26:35ZengElsevierNorth American Spine Society Journal2666-54842025-06-012210056710.1016/j.xnsj.2024.100567Comparison of anterior and posterior approaches for functional improvement in cervical myelopathy: A systematic review and meta-analysis of 33,025 patientsAbdulsalam Aleid, MD0Saud Aldanyowi, MD1Hasan Alaidarous, MD2Zainab Aleid, MD3Abdulaziz Alharthi, MD4Abbas Al Mutair, MD5Department of Surgery, Medical College, King Faisal University, Hofuf, Ahsa, 31982, Saudi ArabiaDepartment of Surgery, Medical College, King Faisal University, Hofuf, Ahsa, 31982, Saudi Arabia; Corresponding author. Department of Surgery, Medical College, King Faisal University, Hofuf, Ahsa, 31982, Saudi Arabia.Department of Surgery, Faculty of Medicine, Albaha University, Saudi ArabiaDepartment of Surgery, Medical College, King Faisal University, Hofuf, Ahsa, 31982, Saudi ArabiaDepartment of Orthopedic Surgery, Alhada Armed Military Hospital, Taif, Saudi ArabiaResearch Center, Almoosa Specialist Hospital, Almoosa College of Health Sciences, Al-Ahsa 36342, Saudi ArabiaABSTRACT: Background: Cervical myelopathy is caused by pressure on the spinal cord in the neck, leading to pain, numbness, and balance issues. Surgery aims to decompress the spinal cord, with different approaches; anterior, posterior, or both depending on specifies. This systematic review and meta-analysis aimed to compare the risks and benefits of anterior and posterior surgical techniques. Methods: Adhering to the PRISMA guidelines, we conducted a systematic search across the databases including PubMed, Scopus, and Web of Science for studies comparing anterior and posterior surgical approaches for cervical myelopathy. Studies that met our predefined inclusion criteria were selected by 2 independent reviewers. The methodological quality of the selected studies was assessed using NOS and Rob-2 tools and analysis was done using the Review Manager tool. One RCT and 22 cohort studies including 33,025 patients were included in the analysis. Results: The anterior approach was associated with better neurological recovery and a greater improvement in Cobb's angle with MD of 4.18 (95%CI: 0.38, 7.91, p=.03), and 6.91 (95%CI: 1.85, 11.97, p=.007), respectively. The anterior approach showed a statistically significant decrease in VAS, and NDI scales with MD of −0.44 (95%CI: −0.75, −0.12, p=.007), and −1.91 (95%CI: −3.74, −0.09, p=.04), respectively as compared to posterior approach. Conclusions: Studies suggest that an anterior approach for cervical myelopathy may improve nerve function, correct spinal curvature more effectively, and lead to fewer complications, less pain, reduced blood loss, and a shorter hospital stay compared to a posterior approach.http://www.sciencedirect.com/science/article/pii/S2666548424002609Spinal cord compressionCervical myelopathyCervical spondylitis myelopathyPosterior approachAnterior approachCervical pain |
| spellingShingle | Abdulsalam Aleid, MD Saud Aldanyowi, MD Hasan Alaidarous, MD Zainab Aleid, MD Abdulaziz Alharthi, MD Abbas Al Mutair, MD Comparison of anterior and posterior approaches for functional improvement in cervical myelopathy: A systematic review and meta-analysis of 33,025 patients North American Spine Society Journal Spinal cord compression Cervical myelopathy Cervical spondylitis myelopathy Posterior approach Anterior approach Cervical pain |
| title | Comparison of anterior and posterior approaches for functional improvement in cervical myelopathy: A systematic review and meta-analysis of 33,025 patients |
| title_full | Comparison of anterior and posterior approaches for functional improvement in cervical myelopathy: A systematic review and meta-analysis of 33,025 patients |
| title_fullStr | Comparison of anterior and posterior approaches for functional improvement in cervical myelopathy: A systematic review and meta-analysis of 33,025 patients |
| title_full_unstemmed | Comparison of anterior and posterior approaches for functional improvement in cervical myelopathy: A systematic review and meta-analysis of 33,025 patients |
| title_short | Comparison of anterior and posterior approaches for functional improvement in cervical myelopathy: A systematic review and meta-analysis of 33,025 patients |
| title_sort | comparison of anterior and posterior approaches for functional improvement in cervical myelopathy a systematic review and meta analysis of 33 025 patients |
| topic | Spinal cord compression Cervical myelopathy Cervical spondylitis myelopathy Posterior approach Anterior approach Cervical pain |
| url | http://www.sciencedirect.com/science/article/pii/S2666548424002609 |
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