前路颈椎间盘切除融合术:独立椎间融合器vs传统椎间融合器Meta分析  

Anterior cervical discectomy and fusion:Meta analysis of independent versus traditional intervertebral fusion cages

作　　者：崔晓伟 张成宝 苏甲 刘金虎 CUI Xiao-wei;ZHANG Cheng-bao;SU Jia;LIU Jin-hu(Department of Orthopedics,The Third People′s Hospital of Shangqiu,Shangqiu,Henan 476000,China)

机构地区：[1]商丘市第三人民医院骨科,河南商丘476000

出　　处：《颈腰痛杂志》2024年第6期1099-1113,共15页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的系统分析独立椎间融合器(SAC)与传统椎间融合器钢板技术(ACP)在前路颈椎间盘切除减压融合术(ACDF)中的应用效果及安全性。方法计算机检索2010年1月至2022年6月发表的关于SAC和ACP对比的中、英文文献,采用纽卡斯尔-渥太华量表(NOS)质量评估后进行Meta分析。结果共纳入26篇文献,均为队列性研究,共计1470例患者。Meta分析显示,SAC和ACP在住院时间、融合率、融合时间、临床疗效优良率、术后1个月C 2-7 Cobb角、术后6个月C 2-7 Cobb角、术后12个月C 2-7 Cobb角、术后融合节段Cobb角、术后3个月融合节段Cobb角、术后6个月融合节段Cobb角、术后椎间高度、术后1个月椎间高度、术后3个月椎间高度、术后6个月椎间高度、末次随访椎间高度、术后JOA评分、术后1个月JOA评分、术后3个月JOA评分、术后6个月JOA评分、术后12个月JOA评分、术后1个月VAS评分、术后3个月VAS评分、末次随访VAS评分、术后3个月NDI指数、术后12个月NDI指数、末次随访NDI指数等方面差异无统计学意义。SAC组的手术时间、术中失血量、术后吞咽困难、术后2周吞咽困难、术后3个月吞咽困难、术后>3个月吞咽困难、邻近节段退变、术后C 2-7 Cobb角、术后3个月C 2-7 Cobb角、末次随访C 2-7 Cobb角、末次随访融合节段Cobb角、术后12个月椎间高度、术后12个月VAS评分明显减少。SAC组的术后3个月内Cage沉降、末次随访Cage沉降明显增加。结论SAC可增加Cage沉降和减少颈椎前凸恢复,但其对术中和术后短期指标的影响优于传统的ACP技术。Objective To systematically explore the effect and safety of stand alone cage(SAC)and traditional anterior cervical plate(ACP)in anterior cervical discectomy decompression and fusion(ACDF).Methods The Chinese and English literatures on the comparison of sac and ACP published from January 2010 to June 2022 were searched by computer,and meta-analysis was carried out after quality evaluation with Newcastle Ottawa scale(NOS).Results A total of 26 literatures were included,all of which were cohort studies,with a total of 1470 patients.Meta analysis showed that there was no significant difference between sac and ACP in length of stay,fusion rate,fusion time,clinical curative effect excellent rate,C 2-7 Cobb angle 1 month after operation,C 2-7 Cobb angle 6 months after operation,C 2-7 Cobb angle 12 months after operation,Cobb angle of fusion segment after operation,cobb angle of fused segment 3 months after operation,cobb angle of fused segment 6 months after operation,postoperative intervertebral height,postoperative intervertebral height 1 month,intervertebral height at 3 months after operation,intervertebral height at 6 months after operation,intervertebral height at the last follow-up,postoperative JOA score,JOA score at 1 month after operation JOA score at 3 months after operation,JOA score at 6 months after operation,JOA score at 12 months after operation,VAS score at 1 month after operation,VAS score at 3 months after operation,VAS at the last follow-up,NDI at 3 months after operation,NDI at 12 months after operation,NDI at the last follow-up.The operation time,intraoperative blood loss,postoperative dysphagia,dysphagia 2 weeks after operation,dysphagia 3 months after operation,dysphagia 3 months after operation,adjacent segment degeneration,postoperative C 2-7 Cobb angle,postoperative 3 months C 2-7 Cobb angle,C 2-7 Cobb angle at the last follow-up,fused segment Cobb angle at the last follow-up,intervertebral height 12 months after operation,VAS score 12 months after operation of SAC group were significantly red

关 键 词：颈椎 椎间盘切除术 脊柱融合 META分析 

分 类 号：R687.3[医药卫生—骨科学]