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Comparison of anterior-only vs combined anterior and posterior fusion for unstable subaxial cervical injuries: A meta-analysis of biomechanical and clinical studies

European Spine Journal Feb 24, 2021

Lee DY, Park YJ, Song MG, et al. - A meta-analysis was conducted to compare biomechanical and clinical outcomes between anterior-only and combined anterior and posterior fusions to ascertain which method of cervical fusion yielded better results for unstable cervical injuries. Researchers carried out to search MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, and SCOPUS electronic databases for relevant articles published through 2000–2019 that compared the biomechanical and clinical outcomes of anterior-only and combined anterior and posterior fusion for unstable cervical fracture. The analysis enrolled eight biomechanical and four clinical studies. The data exhibited that anterior-only and combined anterior and posterior fusions for unstable subaxial cervical injuries can both restore cervical stability. No significant differences were found in clinical outcomes, such as the degree of neurologic improvement and perioperative complications, although combined fusion might have some advantages in terms of stability biomechanically. Thus, the selective use of anterior-only or combined fusion according to the type of injury is recommended, rather than the routine use of combined fusion for unstable cervical injuries.

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