单侧双通道内镜腰椎融合术安全性的荟萃分析  

Safety of unilateral biportal endoscopic lumbar interbody fusion:a meta-analysis

作　　者：邹焱 高子茏 何跃 陈果 姚晓克[1] 顾祖超[1] ZOU Yan;GAO Zi-long;HE Yue;CHEN Guo;YAO Xiao-ke;GU Zu-chao(Department of Orthopedics,First People's Hospital of Chengdu City,Chengdu 610041,China)

机构地区：[1]成都市第一人民医院骨科,四川成都610041

出　　处：《中国矫形外科杂志》2023年第11期1004-1008,共5页Orthopedic Journal of China

基　　金：四川省卫生健康委员会医学科技项目(编号:21PJ138)。

摘　　要：[目的]系统评价单侧双通道内镜(unilateral biportal endoscopic,UBE)辅助腰椎融合术与传统腰椎融合手术的安全性。[方法]检索The Cochrane Library、PubMed、Embase、Web of Science、Clinical Trals.gov、CBM、CNKI、VIP和万方数据库,收集所有UBE与传统腰椎融合手术的对照研究,检索时限均为建库至2022年4月13日,采用RevMan5.3软件进行荟萃分析,对数据不能合并者进行描述性定性分析。[结果]共纳入9篇文献,均为回顾性队列研究,其中高质量文献7篇,中等质量2篇。总共纳入患者796例,其中UBE组365例,传统组431例。荟萃分析结果显示:UBE组和传统组的总并发症发生率(OR=0.94,95%CI 0.57~1.53,P=0.800)、硬膜外血肿发生率(OR=1.16,95%CI 0.38~3.52,P=0.800)、硬脊膜撕裂发生率(OR=1.80,95%CI 0.76~4.30,P=0.180)、感染发生率(OR=0.35,95%CI 0.09~1.30,P=0.120)差异均无统计学意义(P>0.05)。此外,一过性麻木发生率(OR=1.03,95%CI 0.22~4.84,P=0.970)、减压不全发生率(OR=0.97,95%CI 0.18~5.33,P=0.970)、翻修手术发生率(OR=0.78,95%CI 0.17~3.61,P=0.750)、融合器沉降发生率(OR=0.86,95%CI 0.30~2.47,P=0.780)差异均无统计学意义(P>0.05)。[结论]UBE辅助腰椎融合术与传统腰椎融合手术具有同等的安全性。[Objective]To systematically evaluate the safety of unilateral biportal endoscopic(UBE)lumbar interbody fusion versus con-ventional lumbar interbaody fusion surgery.[Methods]The Cochrane Library,PubMed,Embase,Web of Science,Clinical Trals.gov,CBM,CNKI,VIP and Wanfang Database were searched to collect all comparative studies on UBE and conventional lumbar interbody fusion sur-gery from the establishment of the database to April 13,2022,and then RevMan5.3 software was used for meta-analysis,additionally de-scriptive qualitative analysis was performed for data that could not be combined.[Results]A total of 9 articles were enrolled into this study,all of which were retrospective cohort studies,including 7 high-quality articles and 2 medium-quality articles.A total of 796 patients were involved,including 365 in the UBE group and 431 in the conventional group.As results of meta-analysis,there were no significant differenc-es in terms of total complication rates(OR=0.94,95% CI 0.57~1.53,P=0.800),the incidence of epidural hematoma(OR=1.16,95%CI 0.38~3.52,P=0.800),incidence of dural tear(OR=1.80,95%CI 0.76~4.30,P=0.180),and incidence of infection(0R=0.35,95% CI 0.09~1.30,P=0.120)perioperatively between the UBE and traditional groups.Furthermore,there were no significant differences in terms of incidence of transient numbness(OR=1.03,95% CI 0.22~4.84,P=0.970),incidence of incomplete decompression(OR=0.97,95% CI 0.18~5.33,P=0.970)and incidence of revision surgery(0R=0.78,95%CI 0.17~3.61,P=0.750),and incidence of cage subsidence(OR=0.86,95% CI 0.30~2.47,P=0.780)between the two groups.[Conclusion]UBE lumbar interbody fusion is as safe as conventional lumbar interbody fusion sur-gery.

关 键 词：单侧双通道内镜 腰椎融合术 微创手术 荟萃分析 

分 类 号：R687[医药卫生—骨科学]