微创与开放经椎间孔椎体间融合治疗腰椎滑脱的Meta分析

发布时间：2018-12-16 22:37

【摘要】：背景:微创经椎间孔椎间融合治疗腰椎滑脱具有组织损伤小、术中出血少、术后住院时间短等优势,但其与开放经椎间孔椎体间融合治疗腰椎滑脱的疗效比较没有经过严格的循证医学检验。目的:系统性评价微创经椎间孔椎体间融合和开放经椎间孔椎体间融合治疗腰椎滑脱的临床疗效及安全性。方法:计算机检索万方数据库、CNKI、PubM ed、Cochrane Library等数据库,以腰椎滑脱、微创、开放、经椎间孔椎体间融合术、minimally invasive、open transforaminal lumbar interbody fusion、微创经椎间孔椎体间融合、开放经椎间孔椎体间融合等为检索词。由2名作者独立对纳入的文献进行质量评价及数据提取,用Rev Man 5.3软件进行Meta分析。结果与结论:共纳入10篇文献,其中回顾性研究7篇,随机对照研究3篇,共纳入病例963例,微创组489例,开放组474例。(1)Meta分析结果显示:在手术时间、术后并发症发生率、末次随访融合率等方面2组差异无显著性意义,说明2种术式均能明显改善患者疼痛及功能障碍;(2)在术中出血量、术中射线暴露时间等方面差异有显著性意义;(3)结果说明,微创经椎间孔椎体间融合创伤小、术中及术后出血少,与开放经椎间孔椎体间融合相比具有相似的术后功能改善情况,且不增加手术时间和并发症的发生率,是一种安全、有效的手术方式。
[Abstract]:Background: minimally invasive transforaminal fusion for lumbar spondylolisthesis has the advantages of less tissue damage, less intraoperative bleeding, and shorter hospital stay after operation. However, the efficacy of open transforaminal interbody fusion in the treatment of lumbar spondylolisthesis has not been strictly tested by evidence-based medicine. Objective: to evaluate the clinical efficacy and safety of minimally invasive transforaminal fusion and open transforaminal interbody fusion in the treatment of lumbar spondylolisthesis. Methods: the database of Wanfang, CNKI,PubM ed,Cochrane Library and so on were searched with lumbar spondylolisthesis, minimally invasive, open, interbody fusion through intervertebral foramen and minimally invasive,open transforaminal lumbar interbody fusion, minimally invasive interbody fusion of intervertebral foramen. Open intervertebral fusion through intervertebral foramen is the key word. The quality evaluation and data extraction were carried out by two authors, and Meta analysis was carried out with Rev Man 5.3 software. Results and conclusion: a total of 10 articles were included, including 7 retrospective studies and 3 randomized controlled studies. A total of 963 cases were included, 489 cases in the minimally invasive group and 474 cases in the open group. (1) the results of Meta analysis showed that the time of operation was in the operation time. There was no significant difference in the incidence of postoperative complications and the fusion rate of the last follow-up between the two groups, indicating that the two methods could significantly improve the pain and dysfunction of the patients. (2) there were significant differences in the amount of intraoperative bleeding and the time of radiation exposure during the operation. (3) the results showed that the minimally invasive transforaminal fusion had less trauma, less intraoperative and postoperative bleeding, similar to the open transforaminal interbody fusion, and did not increase the operative time and the incidence of complications. It is a safe and effective method of operation.
【作者单位】：天津医科大学研究生院;天津市天津医院;
【基金】：国家自然科学基金资助项目(81272046,31670983) 天津市卫计委攻关课题(14KG121) 天津市自然科学基金课题(15JCYBJC25300)~~
【分类号】：R687.3

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