腰椎后路椎体间融合术与后外侧融合术治疗腰椎退行性疾病的系统评价  

Systematic review for the treatment of degenerative diseases with the lumbar posterior lumbar interbody fusion(PLIF) and posterolateral fusion(PLF)

作　　者：崔兆辉[1] 滕元君[1] 夏亚一[1] 汪静[1] 姜金[1] 陈少龙[1] 

机构地区：[1]兰州大学第二医院骨科,甘肃兰州730000

出　　处：《中国矫形外科杂志》2013年第17期1713-1719,共7页Orthopedic Journal of China

摘　　要：[目的]系统评价腰椎后路椎体间融合术(posterior lumbar interbody fusion)对比后外侧融合术(posterolat-eral fusion)治疗腰椎退行性疾病的术后疗效。[方法]计算机检索PubMed、EMBASE、CNKI、CBM等数据库、学术会议资料和学位论文等。全面收集有关两种方法治疗腰椎退行性疾病的文献。制定文献纳入及排除标准,由2名研究者分别独立筛选文献,按照Cochrane Handbook 5.1进行严格的质量评估,并用Revman 5.2软件进行Meta分析。[结果]经过筛选,共有6篇研究符合纳入标准,包括487例患者被纳入分析。Meta分析结果显示,PLIF组的融合率>PLF组[OR=3.90,95%CI(2.05,7.40),P<0.001],但PLIF组术后1年ODI评分<PLF组[WMD=-3.86,95%CI(-7.59,-0.13),P=0.04],差异具有统计学意义(P<0.05);而两组在手术时间[WMD=15.85,95%CI(-16.25,47.96),P=0.33]、术中失血量[WMD=-90.57,95%CI(-292.50,111.36),P=0.38]术后并发症[OR=0.99,95%CI(0.22,4.47),P=0.99]、二次手术率[OR=0.87,95%CI(0.52,1.45),P=0.25]无统计学差异(P>0.5)。[结论]PLIF手术方式的骨融合率较高,但术后1年ODI评分低于PLF组,且两组在手术时间、术中失血量、术后并发症、二次手术率方面结果相似。[Objective]To systematically evaluate the effects of posterior lumbar interbody fusion（PLIF） and posterolateral fusion（PLF） for lumbar degenerative disease.[Methods]An electronic search for the eligible randomized controlled trials（RCTs） was conducted in the databases of PubMed,Embase,CNKI,and the Chinese Biomedical Literature Database（CBM）.Two researchers independently completed literature selection and data collection,the assessment of methodological quality was conducted in accordance with the Cochrane Handbook 5.1.Meta-analysis was performed using the RevMan 5.1 software.[Results]Six studies involving 487 patients were included.The results of meta-analysis showed that the PLIF had a higher rate of fusion with less ODI score in postoperative 1 year,and both had statistical differences（P＆lt;0.05）.However,both groups were similar in operation time,blood loss,the rates of complicationsand secondary surgery.[Conclusion]Compared with PLF,the PLIF has a significantly higher rate of fusion with less ODI score in postoperative 1 year,and there Is no significant difference in operation time,blood loss,the rates of complications and secondary surgery.

关 键 词：腰椎退行性疾病 腰椎后路椎体间融合术 后外侧融合术 META分析 

分 类 号：R687.3[医药卫生—骨科学]