关于胸腰椎爆裂性骨折前后路手术选择的Meta分析

发布时间：2019-05-19 08:02

【摘要】：目的:通过比较前路、后路手术治疗胸腰椎爆裂性骨折的疗效来确定适合的治疗方式。方法:检索MEDLINE(Pub Med)、Embase和Cochrane Central Registry of Controlled Trials中关于胸腰椎爆裂性骨折前后路手术选择的相关文献,对2014年10月之前相关的随机对照实验和对比观察实验进行归纳,对纳入文献的质量进行评价后,提取所有文献中实验设计、病例特征、干扰因素、随访率及时间、实验结果并分析。结果:纳入7项实验,包括2项随机对照实验、5项对比观察实验,共382名患者。后路手术组在术后脊柱后凸畸形矫正(P0.00001)和随访末脊柱后凸畸形矫正(P0.00001)要优于前路手术组,两组在随访末神经功能改善(P=0.14)、术后并发症(P=0.38)、因器械引起的术后并发症(P=0.41)方面无明显差异;在手术时间(P=0.003)、手术平均失血量(P0.00001)、住院时间(P0.00001)上,前路手术组均显著高于后路手术组;后路手术组的术后椎管内侵占水平(P0.00001)较前路手术组高。结论:后路手术在纠正脊柱后突畸形方面有良好的效果,而且具有手术出血量更少、手术时间及住院时间更短等特点,两种术式在术后并发症及患者健康状况调查问卷(SF-36)中大部分指标上无明显差异,本研究纳入样本量较小可能导致结果的偏倚。
[Abstract]:Objective: to compare the curative effect of anterior and posterior surgery in the treatment of thoracolumbar burst fracture. Methods: the literature on the selection of anterior and posterior approach for thoracolumbar burst fracture in MEDLINE (Pub Med), Embase and Cochrane Central Registry of Controlled Trials was searched, and the related randomized controlled trials and comparative observation experiments before October 2014 were summarized. After evaluating the quality of the included literature, the experimental design, case characteristics, interference factors, follow-up rate and time, experimental results were extracted and analyzed. Results: a total of 382 patients were included in 7 trials, including 2 randomized controlled trials and 5 comparative observation experiments. The correction of kyphosis after operation (P0.00001) and the correction of kyphosis at the end of follow-up (P0.00001) in the posterior operation group were better than those in the anterior operation group. At the end of follow-up, the neurological function of the two groups was improved (P 鈮，

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