郭永强,万宣.椎间植骨融合内固定术治疗退行性脊柱侧弯的系统评价和Meta分析[J].实用中西医结合临床,2020,20(18): |
椎间植骨融合内固定术治疗退行性脊柱侧弯的系统评价和Meta分析 |
Systematic evaluation and meta-analysis of interbody fusion and internal fixation for degenerative scoliosis |
投稿时间:2020-10-14 修订日期:2020-11-07 |
DOI: |
中文关键词: 退行性脊柱侧弯 椎间植骨融合内固定术 单纯椎管减压 系统评价 Meta分析 |
英文关键词: degenerative scoliosis intervertebral bone fusion and internal fixation simple spinal canal decompression systematic review Meta analysis |
基金项目:江西省中医药科研项目(2019B023);江西省卫生与计划生育委员会资助项目(2018A133 ) |
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中文摘要: |
目的:通过系统评价椎间植骨融合内固定术治疗成人退行性脊柱侧弯(adult degenerative scoliosis, ADS)的临床疗效和安全性。方法:计算机检索CNKI、WanFang、VIP、CBM、Cochrane library以及PubMed数据库中有关椎间植骨融合内固定术治疗ADS的临床研究,检索时间均由建库至2020年6月,并采用REVMAN5.4软件进行Meta分析。结果:最终纳入14篇临床随机对照试验(randomized controlled trials,RCTs),共计1020例患者;Meta分析结果表明:椎间植骨融合内固定术治疗的观察组在临床疗效的总有效率(OR=5.29,95%CI(3.33,8.41),Z=7.05,P<0.00001)、术后Cobb角测量(SMD=-3.92,95%CI(-4.97,-2.88),Z=7.34,P<0.0001)、术后JOA评分(SMD=1.64,95%CI(0.40,2.89),Z=2.59,P=0.010)以及术后VAS评分(SMD=-4.90,95%CI(-7.12,-2.68),Z=4.32,P<0.0001)方面均优于单纯椎管减压治疗的对照组。结论:椎间植骨融合内固定术治疗ADS临床疗效肯定、安全性可靠,是一种值得推广的治疗方式。 |
英文摘要: |
Objective: To systematically evaluate the clinical efficacy and safety of intervertebral bone graft fusion and internal fixation in the treatment of adult degenerative scoliosis (ADS).Methods: A computer search of CNKI, WanFang, VIP, CBM, Cochrane library, and PubMed databases for clinical studies on the treatment of ADS with intervertebral bone graft fusion and internal fixation. The search time was from the establishment of the database to June 2020, and REVMAN5.4 was used. The software performs Meta analysis.Results: 14 randomized controlled trials (RCTs) were finally included, with a total of 1020 patients; the results of the Meta analysis showed that: the total effective rate of the observation group in the treatment of intervertebral bone graft fusion and internal fixation (OR= 5.29, 95%CI (3.33, 8.41), Z=7.05, P<0.00001), postoperative Cobb angle measurement (SMD=-3.92, 95%CI (-4.97,-2.88), Z=7.34, P<0.0001) , Postoperative JOA score (SMD=1.64, 95%CI (0.40, 2.89), Z=2.59, P=0.010) and postoperative VAS score (SMD=-4.90, 95%CI (-7.12,-2.68), Z =4.32, P<0.0001) were better than the control group treated with spinal decompression alone.Conclusion: Intervertebral bone graft fusion and internal fixation in the treatment of ADS have a positive clinical effect and reliable safety. It is a treatment method worth promoting. |
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