Bryan、ProDisc C、Prestige ST人工颈椎间盘置换治疗颈椎病远期疗效的系统评价  

Effects of Bryan、ProDisc C or Prestige ST cervical disc replacement versus anterior cervical discectomy and fusion for degenerative cervical syndrome:a systematic review

作　　者：郝俊龙[1] 陈永刚[1] 夏亚一[2] 汪玉良[1] 王栓科[1] 汪静[2] 王翠芳[2] 耿彬[2] 

机构地区：[1]兰州大学第二医院骨科,兰州730000 [2]兰州大学第二医院骨科研究所,兰州730000

出　　处：《中国矫形外科杂志》2011年第7期549-553,共5页Orthopedic Journal of China

摘　　要：[目的]对随访24个月后的Bryan、ProDisc C、Prestige ST颈椎间盘置换术治疗颈椎病的安全性和有效性进行系统评价。[方法]按照Cochrane协作网制订的检索策略进行检索,计算机检索MEDLINE（1966-2010年9月）、EMBASE（1974-2010年9月）、Cochrane图书馆（2010年第9期）、中国生物医学文献数据库（CBM,1978-2010年9月）、中国期刊全文数据库（CNKI,1994-2010年9月）、中文科技期刊全文数据库（VIP,1989-2010年9月）及万方数据库（1979-2010年9月）。手工检索相关的中英文骨科杂志和会议论文。纳入随访时间在24个月以上的颈椎间盘置换术与颈椎间盘减压融合术治疗颈椎病的所有随机对照试验,由两名评价员独立提取资料,并对其方法学质量进行评价。对符合纳入标准的研究用RevMan 5.0软件进行Meta分析。[结果]共纳入7个试验,1 064例患者。Meta分析结果显示：Bryan、ProDisc C、Prestige ST颈椎间盘置换术比颈椎间盘减压融合术在手术时间、出血量和住院时间方面大部分指标未显示出显著优越性（P〉0.05）;在随访24个月后,Bryan、ProDisc C、Prestige ST比颈椎间盘减压融合术在术后VAS,NDI,和SF-36中大部分指标也未有显著的提高（P〉0.05）。[结论]Bryan、Pro-Disc C、Prestige ST颈椎间盘置换与颈椎间盘减压融合术在一般情况和术后远期疗效评价方面差异不大。限于纳入研究在方法学方面的局限性,尚需开展大样本、高质量的RCT,进一步论证其疗效和安全性。[Objective]To assess the efficacy and safety of postoperative effects of Bryan,ProDisc C or Prestige ST cervical disc replacement versus anterior cervical discectomy and fusion for degenerative cervical syndrome. [Methods]The author searched the Cochrane Central Register of Controlled Trials（CENTRAL）（Issue 9,2010）,MEDLINE,EMBASE,CBM,CNKI,VIP,Wanfang database,etc.from their inception to June 2010.Some relevant journals were handsearched as well.Two reviewers independently evaluated the quality of the included studies and extracted the data.Meta-analysis was performed by RevMan 5.0 software.[Results]Seven trials involving 1 064 patients were included.In terms of operative time,blood loss and hospital stay,Bryan,ProDisc C or Prestige ST cervical disc replacement showed no significantly superior effects to anterior cervical discectomy and fusion.VAS,NDI,and SF-36 had no significant improvement on clinical scores after 24 months of follow-up.[Conclusion]Bryan,ProDisc C or Prestige ST cervical disc replacement did not have significant improvement compared to anterior cervical discectomy and fusion in terms of long-term effects.However,there is a moderate possibility of selection bias,performance bias and publication bias in this review because of the small number of the included studies,which weakens the strength of the evidence of this results.Larger sample size,higher quality RCTs are needed.

关 键 词：颈椎间盘置换术 颈前路椎间盘减压融合术 Meta分析 系统评价 随机对照试验 

分 类 号：R687.3[医药卫生—骨科学]