经皮穿刺与传统开放椎弓根螺钉内固定术治疗胸腰椎骨折的Meta分析  

Comparison of percutaneous versus open pedicle screw fixation for thoracolumbar fractures:a Meta analysis

作　　者：田中[1] 邓忠良[2] 

机构地区：[1]重钢总医院骨科,400080 [2]重庆医科大学附属第二医院骨科,400010

出　　处：《重庆医学》2015年第6期810-812,共3页Chongqing medicine

摘　　要：目的比较经皮穿刺与传统开放椎弓根螺钉内固定技术治疗胸腰椎骨折的疗效及安全性。方法采用Cochrane系统评价方法,计算机检索PUBMED、OVID和Cochrane CENTRAL外文数据库,符合入选标准的文献由2名评价者独立筛选及评估,采用RevMan5.2.6软件进行Meta分析。结果 7篇文献（共353例患者）被纳入分析,结果显示经皮穿刺较传统开放椎弓根螺钉内固定技术治疗胸腰椎骨折术中失血量（RR=1.89,95%CI：1.55~2.29）和手术时间（RR=1.21,95%CI：1.12~1.30）比较,差异有统计学意义（P〈0.05）,且经皮穿刺组矫正矢状后凸角、改善椎体前缘高度与传统开放组比较,差异无统计学意义（P〉0.05）。结论经皮穿刺及传统开放椎弓根螺钉内固定技术都是安全有效的治疗胸腰椎骨折的内固定方法,但是经皮穿刺相对于传统开放椎弓根螺钉内固定技术创伤更小、失血更少、手术时间更短。Objective To compare the feasibility and efficacy of PPSF with OPSF for thoracolumbar fractures.Methods We searched the PUBMED,OVID and Cochrane CENTRAL databases through Jan 2014.All of the clinical trials included were extracted and evaluated by two reviewers independently.Data were analyzed using RevMan 5.2.6software by the Cochrane Collaboration.Results Seven studies including 353 patients met the inclusion criteria.The Meta analysis found there were significant differences between the two procedures in intraoperation blood loss（RR=1.89,95%CI：1.55-2.29,P〈0.05）and operation time（RR=1.21,95%CI：1.12-1.30,P〈0.05）.For the correction of sagittal Cobb′s angle and the anterior vertebral body height,analysis did not find any significant difference between the PPSF and OPSF（P〉0.05）.Conclusion Both PPSF and OPSF are safe and efficacious internal fixation methods for treating thoracolumbar fractures,while,PPSF may cause less blood loss and cost less time.

关 键 词：椎弓根螺钉 胸腰椎骨折 META分析 经皮 开放 

分 类 号：R687.3[医药卫生—骨科学]