Dynesys动态稳定系统与腰椎后路椎体间融合术术后疗效的Meta分析  

M eta-analysis of postoperative effects of dynamic neutralization system (Dynesys) compared with posterior lumbar interbody fusion (PLIF)

作　　者：王秉翔[1] 聂林[1] 蒲华清[2] 张志勉[2] 

机构地区：[1]山东大学齐鲁医院脊柱外科,济南250012 [2]山东大学齐鲁医院健康体检中心,济南250012

出　　处：《山东大学学报（医学版）》2013年第9期72-78,共7页Journal of Shandong University:Health Sciences

摘　　要：目的系统评价Dynesys手术与传统腰椎后路椎体间融合术(PLIF)术后疗效。方法检索Pubmed、Medline、Embase、中国知网、中国生物医学文献数据库、万方数据库,将纳入文献应用Stata SE 11.2软件进行Meta分析。结果共7篇文献符合纳入标准,累计病例359例,其中Dynesys组159例,PLIF组200例。有关指标的SMD及其95%CI为:手术时间,-1.34(-1.95^-0.73);术中出血量-1.28(-2.18^-0.38);术后VAS评分,0.03(-0.35~0.41);术后ODI指数,-0.07(-0.30~0.17);术后手术节段ROM,4.57(3.29~5.85);术后手术相邻节段ROM,-1.36(-2.32^-0.40)。结论 Dynesys手术在缩短手术时间、减少术中出血量方面较PLIF有明显优势。两种手术在改善术后VAS、ODI方面具有相同效果,Dynesys手术可有效保留手术节段的活动度,并减缓手术相邻节段活动度的增加。Objective To assess the postoperative effects of two different surgical methods--Dynesys and posterior lum- bar interbody fushion（PLIF）. Methods Literatures about postoperative effects of Dynesys compared with PLIF from 1994 to 2013 were collected. Stata SE 11.2 software was applied to analyze the included literatures. Results A total of 359 cases （ 159 cases for Dynesys, 200 cases for PLIF） in 7 literatures were included. The SMD and 95% C1 of the related indicators were as follows：operation time, - 1.34 （ - 1.95-- -0.73 ） ; bleeding volume, - 1.28 （ -2.18-- -0.38） ; postoperative VAS, 0. 03 （ - 0. 35---4）. 41 ） ; postoperative ODI, -0.07（-0.30--0.17） ; operated segment ROM, 4.57 （3.29--5.85） ; and adjacent segment ROM, - 1.36 （ - 2.32-- - 0.40）. Conclusion The results indi- cate that Dynesys has significant advantage on decreasing operation time and bleeding volume. There is no significant difference in postoperative VAS and ODI between the two surgical methods. Dynesys can maintain mobility of operated segment without the ROM of adjacent segment increased.

关 键 词：DYNESYS 腰椎后路椎体间融合术 临床疗效 META分析 

分 类 号：R681.5[医药卫生—骨科学]