经皮椎弓根螺钉内固定治疗胸腰椎化脓性脊柱炎安全性和有效性的Meta分析  

Meta analysis of safety and effectiveness of percutaneous pedicle screw internal fixation for the treatment of thoracolumbar pyogenic spondylodiscitis

作　　者：栗林 徐铖菡 邝孝坤 骆聪聪 王彦金 柴旭斌 禚汉杰 周英杰 LI lin;XU Chenghan;KUANG Xiaokun;LUO Congcong;WANG Yanjin;CHAI Xubin;ZHUO Hanjie;ZHOU Yingjie(不详;Henan University of Chinese Medicine,Zhengzhou,Henan 450046,China)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南省洛阳正骨医院(河南省骨科医院)脊柱外二科,河南洛阳471002

出　　处：《中国骨与关节损伤杂志》2024年第9期903-907,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的采用Meta分析经皮椎弓根螺钉内固定治疗胸腰椎化脓性脊柱炎的安全性和有效性。方法通过PubMed、Embase、The Cochrane Library、Web of Science数据库检索有关经皮椎弓根螺钉(Percutaneous pedicle screw,PPS)与开放式椎弓根螺钉(Open pedicle screw,OPS)内固定治疗胸腰椎化脓性脊柱炎的文献,2名评价员根据Cochrane协作网提供的评价标准,对所有考虑纳入分析的研究进行偏倚风险评估,汇总商讨后决定纳入文献并排除争议文献。结果纳入7篇文献,共722例,其中PPS组342例,OPS组380例。Meta分析结果显示PPS组手术时长、术中失血量、术后感染率、术后疼痛、住院时长优于OPS组,差异有统计学意义(P<0.05),两组术后螺钉错位率、螺钉松动率差异无统计学意义(P>0.05)。结论经皮椎弓根螺钉内固定治疗胸腰椎化脓性脊柱炎在手术时长、术中失血量、术后感染率、术后疼痛、住院时长方面优于开放式椎弓根螺钉内固定术,但两种术式在螺钉错位、螺钉松动方面并无差异。Objective To study the safety and effectiveness of percutaneous pedicle screw(PPS)internal fixation in the treatment of thoracolumbar pyogenic spondylodiscitis with Meta analysis.Methods Literature searches were conducted in PubMed,Embase,the Cochrane Library,and Web of Science databases for studies comparing PPS and open pedicle screw(OPS)fixation for thoracolumbar pyogenic spondylodiscitis.Two reviewers evaluated the risk of bias in all eligible studies according to the Cochrane Collaboration criteria.After discussion,studies were selected for inclusion and contentious studies were excluded.Results Seven studies involving a total of 722 cases were included:342 cases in the PPS group and 380 cases in the OPS group.Meta-analysis results indicated that the PPS group had statistically significant advantages over the OPS group in terms of operation duration,intraoperative blood loss,postoperative infection rate,postoperative pain,and length of hospital stay(P<0.05).There was no statistically significant difference between the two groups in terms of screw misplacement and screw loosening rates(P>0.05).Conclusion Percutaneous pedicle screw internal fixation demonstrates superior outcomes compared to open pedicle screw fixation in terms of operation duration,intraoperative blood loss,postoperative infection rate,postoperative pain,and length of hospital stay for the treatment of thoracolumbar pyogenic spondylodiscitis.However,there is no significant difference between the two techniques in terms of screw misplacement and screw loosening.

关 键 词：化脓性脊柱炎 椎弓根钉 经皮 内固定 安全性 

分 类 号：R681.5[医药卫生—骨科学]