Tantalum Fusion Device in Anterior Cervical Discectomy and Fusion For Treatment of Cervical Degeneration Disease

Abstract

Study Design: This is a systematic review and meta-analysis study. Objective: The purpose of this systematic review and meta-analysis study is to evaluate the outcomes of a tantalum fusion device in anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degeneration disease. Summary of Background Data: A great interest has raised for porous tantalum in cervical fusion, but several studies reported the divergent clinical outcome and fusion rate. No systematic review and meta-analysis has been conducted up to present to evaluate the outcomes of the tantalum fusion device. Methods: We comprehensively searched multiple databases for studies that investigated the tantalum fusion device in ACDF. The retrieved results were last updated on February 15, 2018. Outcomes of interest comprised of operative parameters, fusion rate, the incidence of adverse events as well as patient-reported outcomes, including the Neck Disability Index (NDI) score, Visual Analog Scale (VAS) score, Short Form-36 Physical Component Scores and complications. Results: Ten studies included were included in this review and 6 randomized controlled trial studies included. All studies were pooled to evaluate the outcome of fusion rate, NDI, and VAS after tantalum fusion treatment. The results of the meta-analysis showed that implantation of the tantalum fusion device is associated with significantly shorter operative and fewer adverse events when compared with autologous iliac crest bone graft. However, no difference was found with regards to the fusion rate, NDI, VAS, and global assessment. Conclusions: Through this systemic review and meta-analysis, no significant difference was found with regards to fusion rate, postoperative NDI, and VAS between tantalum fusion and iliac crest bone graft in ACDF. More longer-term and randomized studies with large samples are warranted to validate any association found in this study. Level of Evidence: Level II.