钉道强化术治疗伴骨质疏松胸腰椎疾病疗效的Meta分析  

Efficacy of Pedicle Screw Augmentation for Thoracolumbar Disease with Osteoporosis:a Meta-analysis.

作　　者：王东平 陈浩谚 庄文德 谢炜星[2] 晋大祥[2] Wang Dongping;Chen Haoyan;Zhuang Wende(The First Clinical Medical College of Guangzhou University of Chinese Medicine,Guangdong 510405,China)

机构地区：[1]广州中医药大学第一临床医学院,510450 [2]广州中医药大学第一附属医院,510000

出　　处：《医学研究杂志》2021年第4期59-64,共6页Journal of Medical Research

基　　金：广东省科学技术厅资助项目(2016A020226007)。

摘　　要：目的评价钉道强化术治疗伴骨质疏松胸腰椎疾病的疗效及安全性。方法运用计算机检索从建库时间至2020年1月1日的PubMed、Web of Science、Medline、Embase、Cochrane Library、中国知网和万方等数据库,搜索关于钉道强化术与传统置钉术治疗伴骨质疏松胸腰椎疾病的随机对照研究,由两位作者独立评估各文献研究的质量。且将各研究中的术后VAS、JOA、ODI评分、手术时间、术中出血量和矫正角度丢失等提取并整理为表格,并将该研究数据利用Review Manager 5.3软件进行Meta分析。结果共计有7篇文献符合研究标准,540例患者被纳入分析数据库。钉道强化术与传统置钉术比较,术后JOA评分改善和矫正角度维持较好,差异有统计学意义(P<0.05),但钉道强化术的手术时间较长。术后VAS、ODI评分和手术出血量比较差异无统计学意义(P>0.05)。结论与传统置钉术比较,钉道强化术治疗伴骨质疏松胸腰椎疾病能改善术后JOA评分和预防矫正角度丢失。由于纳入文献存在研究数量不足等局限性,上述结论在未来仍需要多中心、大样本和高质量的研究来验证。Objective To evaluate the efficacy and safety of pedicle screw augmentation in the treatment of thoracolumbar diseases with osteoporosis.Methods We used computer to search PubMed,Web of Science,Medline,Embase,Cochrane Library,China Knowledge Network and Wanfang databases from database establishment to January 1,2020 to search for the randomized controlled study of pedicle screw augmentation and traditional pedicle screw placement in the treatment of thoracolumbar diseases with osteoporosis.Two authors independently evaluated the quality of each literature.The postoperative VAS scores,JOA scores,ODI scores,operative time,intraoperative bleeding volume and loss of correction angle in each study were extracted and organized into tables.The research data were analyzed using Review Manager 5.3 software.Results A total of 7 articles met the study criteria and 540 patients were included in the analysis database.We Compared pedicle screw augmentation with traditional pedicle screw placement:the postoperative JOA scores improved and correction angle maintained better,and the difference was statistically significant(P<0.05).However,the operation time of pedicle screw augmentation was longer.There was no significant difference in postoperative VAS scores,ODI scores and surgical bleeding(P>0.05).Conclusion Compared with traditional pedicle screw placement,pedicle screw augmentation in the treatment of thoracolumbar diseases with osteoporosis can improve the JOA scores and prevent the loss of orthopedic angle.Due to the limitations of the included literature such as insufficient number of studies,the above conclusions will still need to be verified by multi-center,large sample and high-quality studies in the future.

关 键 词：钉道强化术 传统置钉术 骨质疏松 胸腰椎疾病 META分析 

分 类 号：R681[医药卫生—骨科学]