髓核摘除结合棘突间分离系统动态固定治疗腰椎间盘突出症效果的Meta分析

发布时间：2018-12-08 08:50

【摘要】：目的系统评价髓核摘除结合棘突间分离系统动态固定治疗腰椎间盘突出症(LDH)的临床疗效。方法计算机检索建库至2016年7月Cochrane Library、Pub Med、Medline、Academic Search Premier、中国生物医学文献数据库、中国知网、维普和万方数据库文献,同时辅助手工检索,收集采用髓核摘除结合棘突间分离系统动态固定与单纯髓核摘除治疗LDH的临床对照研究(分别为观察组和对照组)。采用Revman5.3软件对相关数据进行Meta分析。结果纳入11篇文献,共675例LDH患者,其中观察组312例、对照组363例。Meta分析结果显示,两组手术时间、切口长度、术中出血量比较差异均无统计学意义(P均0.05);观察组术后1年疼痛视觉模拟评分、Oswestry功能障碍指数问卷表评分均低于对照组,术后1年及2年JOA评分、术后优良率、术后责任节段椎间高度均高于对照组(P均0.01)。结论髓核摘除结合棘突间分离系统动态固定治疗LDH疗效好,患者术后责任节段椎间高度维持好、腰背痛残留少。
[Abstract]:Objective to evaluate the clinical effect of nucleus pulposus removal combined with dynamic fixation of interspinous process in the treatment of lumbar disc herniation (LDH). Methods Cochrane Library,Pub Med,Medline,Academic Search Premier, Chinese Biomedical Literature Database, China knowledge Network, Weip and Wanfang databases were searched by computer until July, 2016. To collect the clinical control study of LDH treated by nucleus pulposus extirpation combined with dynamic fixation of spinous process separation system and simple removal of nucleus pulposus (observation group and control group respectively). The related data were analyzed by Meta using Revman5.3 software. Results A total of 675 patients with LDH were included in 11 articles. There were 312 cases in the observation group and 363 cases in the control group. The results of Meta analysis showed that there was no significant difference between the two groups in the operation time, the length of incision and the amount of intraoperative bleeding (P 0.05). The visual analogue score of pain and the score of Oswestry dysfunction index questionnaire in the observation group were lower than those in the control group one year and two years after operation. The excellent and good rate and the intervertebral height of the responsible segment were higher in the observation group than in the control group (all P 0.01). Conclusion the removal of nucleus pulposus combined with dynamic fixation of spinous process separation system is effective in the treatment of LDH.
【作者单位】：滨州医学院附属医院;
【分类号】：R687.3

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