成人腰椎侧弯长节段固定选择不同远端融合椎的荟萃分析

发布时间：2018-03-24 15:48

本文选题：成人腰椎侧弯　切入点：远端融合椎　出处：《中国矫形外科杂志》2017年05期

【摘要】：[目的]荟萃分析长节段融合内固定术治疗成人腰椎侧弯选择不同远端融合椎的术后并发症及矫形效果。[方法]计算机在Pubmed、Ovid、Embase、Web of science、Cochrane Library数据库、中国生物医学文献服务系统(SinoMed)、中国生物医学期刊引文数据库(CMCI)、相关期刊论文(CNKI)中全面检索1996年1月~2015年12月公开发表的文献。由2名评价员独立的根据纳入和排除标准严格筛选提取资料和质量评价后,采用Review Manager 5.2软件进行数据分析。[结果]纳入研究的文献共5篇,共计421例。其中179例选择L_5为远端融合椎,242例选择S1为远端融合椎。荟萃分析显示,术后假关节形成率(P=0.01)远端融合椎选择L_5组优于S_1组,而术后翻修率(P=0.10)、术后ASD发生率(P=0.06)、术后Cobb角改善程度(P=0.74)、术后CVA改善程度(P=0.93)、术后LL改善程度(P=0.44)以及术后SVA改善程度(P=0.57)的比较两组间差异均无统计学意义。[结论]现有的证据表明,对于成人腰椎侧弯患者,远端融合椎选择L_5或是S_1在术后ASD发生率、术后翻修率及矫形效果上未见明显统计学差异,但L_5组假关节发生率低于S_1组。受本文纳入研究文献的数量和质量限制,上述结论尚需更多高质量的随机对照研究论证。
[Abstract]:[objective] to analyze the postoperative complications and orthopedic effects of long segmental fusion internal fixation in the treatment of different distal lumbar fusion vertebrae in adults. [methods] computer was used in the Pubmedmedan Ovidbase of Science Cochrane Library database. The Chinese Biomedical document Service system, China Biomedical Journal citation Database (CMCII), China Journal Full-Text Database (CNKI), is a comprehensive search for literature published from January 1996 to December 2015. After strict screening and extraction of data and evaluation of quality according to the criteria of entry and exclusion, Data were analyzed by Review Manager 5.2 software. [results] A total of 421 cases were included in the study. Among them, 179 cases chose L5 as distal fusion vertebra, 242 cases chose S1 as distal fusion vertebra, and the meta-analysis showed that, The rate of pseudoarthrosis after operation was 0.01) the distal fusion vertebrae was selected as L _ S _ 5 group, which was superior to S _ S _ 1 group. However, the revision rate was 0.10%, the incidence of ASD was 0.06%, the degree of improvement of Cobb angle was 0.74%, the degree of improvement of CVA was 0.93%, the degree of improvement of LL was 0.44) and the degree of improvement of SVA was 0.57). [conclusion] there is no significant difference between the two groups. [conclusion] there is no significant difference between the two groups in the improvement of Cobb angle, the degree of improvement of CVA after operation and the degree of improvement of SVA after operation (P 0.44). [conclusion] there is no significant difference between the two groups. For adult patients with lumbar scoliosis, there was no significant difference in the incidence of ASD, revision rate and orthopedic effect between distal fusion vertebrae L _ 5 and S _ K1, and no significant difference was found in the incidence of postoperative ASD, revision rate and orthopedic effect. However, the incidence of pseudarthrosis in group L5 is lower than that in group S1. Due to the limitation of quantity and quality of the literature included in this study, the above conclusions need more high-quality randomized controlled studies.
【作者单位】：第二军医大学海军临床医学院骨科;海军总医院骨科;
【分类号】：R687.3

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