伤椎置钉短节段内固定和传统短节段内固定治疗胸腰椎骨折疗效的Meta分析  

Meta analysis of transvertebral and conventional short-segmental fixation for thoracolumbar fractures

作　　者：冯睿[1] 马信龙[1,2] 马剑雄[1] 邢丹[1] 王杰[1] 贾浩波[1] 马宝意[2] 朱少文[2] 陈阳[2] 杨阳[2] 虞惊涛[1] 

机构地区：[1]天津医科大学总医院骨科,300052 [2]天津市天津医院骨科

出　　处：《中华创伤杂志》2014年第6期525-529,共5页Chinese Journal of Trauma

基　　金：国家自然科学基金资助项目（81102607）;天津市科技支撑重点资助项目（11ZCGYSY01800）;天津市卫生局科技攻关资助项目（11KG137）

摘　　要：目的通过分析国内外相关文献，评价伤椎置钉短节段内固定和传统短节段内固定治疗胸腰椎骨折的临床疗效。方法计算机检索1990年1月-2012年12月中国知网数据库、Pubmed、Cochrane系统评价资料库、Cochrane临床对照试验中心数据库等中英文数据库，并同时采用手工检索，按照既定的纳入和排除标准查找伤椎置钉短节段内固定和传统内固定比较的相关文献。按照非RCT的方法学指数（methodological index for non—randomized studies，MINORS）对纳入的文献进行质量评价，使用RevMan5．2进行Meta分析的相关计算。结果共纳入13篇文献，患者728例，其中传统短节段内固定441例，传统短节段内固定＋伤椎置钉287例。伤椎置钉短节段内固定与传统短节段内固定比较，在手术前后Cobb角、术后伤椎椎体前缘高度、长期随访Cobb角和伤椎椎体前缘高度方面差异均有统计学意义（P均〈0．05）。结论与传统短节段内固定相比，伤椎置钉短节段内固定可以更好矫正Cobb角并且长期疗效较好，但传统短节段内固定在恢复和维持伤椎高度上优于伤椎置钉短节段内固定。Objective To compare the clinical results of transvertebral versus conventional shortsegmental fixation in treatment of thoraeolumbar fractures by referring to related literatures at home and abroad. Methods Based on the established inclusion and exclusion criteria, studies of transvertebral versus conventional short-segmental fixation for thoraeolumbar fractures were electronically searched from January 1990 to December 2012 using CNKI, PubMed, Coehrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials. A manual search was performed as well. A quality assessment of the included studies was performed using the methodological index for non - randomized studies （MINORS）. Meta analysis was carried out using RevMan 5.2 software. Results Thirteen papers involving 728 cases, of whom 441 had conventional short-segmental fixation and 287 conventional short-segmental fixation plus transvertebral insertion were included. The two methods revealed statistical significances in aspects of Cobb＇ s angles and anterior vertebral body height before and after operation and at the long-term follow-up. Conclusion Transvertebral short-segmental fixation enables more correction of Cobb＇ s angle and better late effect compared with the conventional fixation method, but the latter is superior in restoration and maintenance of vertebral height.

关 键 词：脊柱骨折 胸椎 腰椎 骨折固定术 内 META分析 

分 类 号：R687.3[医药卫生—骨科学]