不同手术入路治疗颈椎后纵韧带骨化症疗效的Meta分析  

Meta analysis of different surgical approach for the cervical ossification of the posterior longitudinal ligament

作　　者：王亚楠[1] 侯海涛[1] 邵诗泽[1] 付松[1] 刘海军[1] 王欢[1] 黄相鹏[1] 王龙强[1] 

机构地区：[1]山东省文登整骨医院脊柱脊髓三科,山东文登264400

出　　处：《中国矫形外科杂志》2016年第15期1384-1389,共6页Orthopedic Journal of China

摘　　要：[目的]系统评价前路或后路入路治疗颈椎后纵韧带骨化症的疗效。[方法]计算机检索PUBMED、MEDLINE、EMBASE、中国生物医学文献数据库、中国期刊全文数据库以及万方数据库中关于前路或后路入路治疗颈椎后纵韧带骨化症的相关研究,对手术时间、术中出血量、术后末次随访JOA评分、颈椎曲度改善率、并发症率等数据行Meta分析。[结果]共有8篇研究纳入,收集病例541例,其中前路组210例,后路组331例。两组相比,末次随访JOA评分、术后颈椎曲度改善率,前路优于后路(P<0.01),手术时间、术中出血量后路少于前路(P<0.05),并发症发生率两组差异无统计学意义。[结论]对于后纵韧带骨化症的治疗,前路手术神经功能恢复及曲度改善较好,后路手术创伤较小,尚不能认为两种入路术后并发症发生率不同,更高等级的临床证据需纳入更多高质量研究支持。[ Objective] To assess the effectiveness of the anterior or posterior approach for cervical OPLL. [ Methods ] Databases such as PUBMED, MEDLINE, EMBASE, Chinese Biomedical Literature Database, the China Academic Journal and Wanfang Database were searched about related research on anterior and posterior approaches for the treatment of cervical OPLL. Operation time, operation blood, postoperative Japanese Orthopedic Association score, change of cervical curvature and complication rate were compared between anterior and posterior groups. [ Results] Eight studies involving 541 patients were in- cluded. There were 210 cases with anterior, and 331 cases with posterior. The results indicated that for postoperative JOA score and change of cervical curvature, anterior approach was better than posterior （P 〈 0. 01 ） ; for operation time and blood, posterior approach was less （P 〈0. 05 ） . There was no significant difference in complication rate between two groups. [ Conclusion] For the treatment of cervical OPLL, the neurological improvement and curvature change of anterior group are better, while trauma of posterior group is less. However, it is still needed more high quality researches to support the conclusion.

关 键 词：颈椎 后纵韧带骨化 手术入路 META分析 

分 类 号：R687.3[医药卫生—骨科学]