微创经皮与传统开放椎弓根螺钉置入固定胸腰椎骨折的文献荟萃

发布时间：2018-02-21 10:49

本文关键词：胸椎腰椎骨折外科手术微创性骨钉内固定器组织工程骨科植入物脊柱植入物胸腰椎骨折微创手术传统开放手术椎弓根螺钉内固定术并发症发生率 CONSORT声明报告质量评价　出处：《中国组织工程研究》2016年13期 　论文类型：期刊论文

【摘要】：背景:研究表明,采用切开复位椎弓根螺钉置入固定胸腰椎骨折可获得满意的效果,并得到广泛的推崇,但其在修复术中和修复后存在潜在风险;而微创经皮椎弓根螺钉技术使软组织创伤和并发症降到最低。微创经皮和传统开放椎弓根螺钉置入内固定修复胸腰椎骨折,何种方法更具优势尚无定论。目的:对微创经皮与传统开放椎弓根螺钉置入内固定修复胸腰椎骨折的疗效和术后并发症进行质量评价和荟萃分析。方法:计算机检索Pub Med、The Cochrane Library、CNKI、Wan Fang、CBM及VIP数据库,手工检索中华骨科杂志、中华创伤骨科杂志、中华创伤杂志等。全面收集微创经皮与传统开放椎弓根螺钉固定治疗胸腰椎骨折的对照试验,检索时限均为建库至2015年,并追溯纳入研究所引用的参考文献。由4位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量,采用Rev Man 5.2软件进行Meta分析。根据CONSORT声明和相关的外科临床评价指标对纳入文献的质量进行综合评价。结果与结论:共纳入28篇文章(25个随机对照试验研究和3个回顾性比较研究),1 285例患者。Meta分析结果显示:与传统开放椎弓根螺钉固定相比,微创经皮椎弓根螺钉置入内固定手术时间短、术中出血量少、住院时间短、术后总体并发症发生率低、病椎高度丢失少(P0.05)。但术后疼痛等级两者差异无显著性意义(P0.05)。提示微创经皮椎弓根螺钉固定治疗胸腰椎骨折安全可靠、创伤小、出血少、恢复快、住院时间短、术后并发症少,中期随访对伤椎畸形的矫正与传统开放手术相当。然而,大多数的相关方法和结果不够详细。建议根据相关标准报告随机对照试验,提高整个随机对照试验的报告质量和真实性。
[Abstract]:Background: open reduction with pedicle screw fixation of thoracolumbar fractures can obtain satisfactory results and is widely respected, but there are potential risks during and after the repair of thoracolumbar fractures. Minimally invasive percutaneous pedicle screw technique minimizes soft tissue trauma and complications. Minimally invasive percutaneous and traditional open pedicle screws are used to repair thoracolumbar fractures. Objective: to evaluate the effect of minimally invasive percutaneous and traditional open pedicle screw placement in the repair of thoracolumbar fractures and postoperative complications. To retrieve the Cochrane Library Pub and VIP database, Chinese Journal of Orthopaedics, Chinese Journal of Orthopedic Trauma, Chinese Journal of Trauma, et al.Compared trials of minimally invasive percutaneous and traditional open pedicle screw fixation for thoracolumbar fractures were collected. The four researchers independently sifted the literature, extracted the data and evaluated the quality according to the inclusion and exclusion criteria. Meta analysis was carried out with Rev Man 5.2 software. The quality of the literature was comprehensively evaluated according to the CONSORT statement and related surgical clinical evaluation indexes. Results and conclusions: 28 articles (25 randomized controlled trial studies and 3. A retrospective comparative study of 1 285 patients. Meta-analysis showed that compared with traditional open pedicle screw fixation, Minimally invasive percutaneous pedicle screw placement for internal fixation had a short operative time, less intraoperative bleeding, shorter hospital stay, and lower overall postoperative complications. However, there was no significant difference in postoperative pain grade between the two groups. It suggested that minimally invasive percutaneous pedicle screw fixation for thoracolumbar fractures was safe, reliable, less traumatic, less bleeding, faster recovery, shorter hospital stay and less postoperative complications. The correction of deformities of injured vertebrae in mid-term follow-up was comparable to that of traditional open surgery. However, most of the related methods and results were not sufficiently detailed. It is recommended that a randomized controlled trial should be reported according to the relevant criteria. Improve the quality and authenticity of the report for the whole randomized controlled trial.
【作者单位】：甘肃省人民医院骨科;甘肃中医药大学研究生院;兰州大学第二医院骨2科;甘肃会宁县人民医院;
【分类号】：R687.3

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