摘要
目的通过Meta分析,比较单纯植骨和椎间融合器植骨融合治疗腰椎退行性疾病的效果。方法检索PubMed、Cochrane Library、Embase、中国知网、万方、维普和中国生物医学文献数据库等中英文数据库,检索时间为从建库起至2020年11月1日,得到相关的文献后,阅读并提取关键数据,利用Review Manager 5.3软件分析数据。结果最终纳入14篇文献(共计1271例)。Meta分析结果提示:单纯植骨组与椎间融合器植骨组的手术时间[MD=-4.50,95%CI(-7.15,-1.85),P=0.0009]、术中出血量[MD=-12.98,95%CI(-20.72,-5.23),P=0.001)]和手术费用[MD=-6395.89,95%CI(-6992.61,-5799.18),P<0.00001]的差异有统计学意义;椎间融合器植骨组与单纯植骨组的术后椎间隙高度[MD=-1.46,95%CI(-1.60,-1.33),P<0.00001]的差异有统计学意义;术后JOA评分、术后腰椎前凸角和并发症发生率比较,差异无统计学意义(P=0.48、P=0.25和P=0.69)。结论在椎间隙融合方式上,椎间融合器植骨能较好地维持术后椎间隙高度,其临床疗效优于单纯植骨。但椎间融合器植骨手术用时偏多,术中出血较多,手术费用较高。在临床椎间融合方式的具体选择中,建议遵循因人制宜的原则。
Objective To compare the effects of simple bone graft fusion and intervertebral fusion cage bone grafting in the treatment of lumbar degenerative diseases through Meta-analysis.Methods The study searched PubMed,Cochrane Library,Embase,CNKI,Wanfang,VIP and China Biomedical Literature Database and other Chinese and English databases.The search time was from the establishment of the database to November 1,2020.After obtaining the relevant literatures,key data were read,extracted,and analyzed using Review Manager 5.3 software.Results Fourteen articles were finally included(a total of 1 271 cases).Meta-analysis indicated that the operation time [MD=-4.50,95%CI(-7.15,-1.85),P=0.0009],intraoperative blood loss [MD=-12.98,95%CI(-20.72,-5.23),P=0.001] and the surgical cost [MD=-6 395.89,95%CI(-6 992.61,-5 799.18),P<0.000 01] of simple bone grafting fusion and intervertebral fusion cage bone grafting were statistically significant.The postoperative intervertebral space height of intervertebral fusion cage bone grafting and simple bone grafting fusion [MD=-1.46,95%CI(-1.60,-1.33),P<0.000 01] was statistically significant.The postoperative JOA score,the postoperative lumbar lordosis angle and the incidence of complications were not statistically significant(P=0.48,P=0.25 and P=0.69).Conclusion In terms of intervertebral space fusion,intervertebral fusion cage bone grafting can better maintain the height of the intervertebral space after surgery,and its clinical efficacy are better than simple bone grafting fusion.However,the operation of bone grafting with intervertebral fusion cage bone grafting takes more time,has more bleeding during the operation,and costs higher.In the specific selection of clinical intervertebral fusion,it is recommended to follow the principle of adapting measures to individual conditions.
作者
王东平
陈浩谚
庄文德
谢炜星
晋大祥
Wang Dongping;Chen Haoyan;Zhuang Wende;Xie Weixing;Jin Daxiang(First Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou Guangdong,510405;Department of Orthopedics,The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou Guangdong,510405,China)
出处
《生物骨科材料与临床研究》
CAS
2021年第6期45-53,共9页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
椎间融合器植骨
单纯植骨融合
退行性腰椎疾病
META分析
Intervertebral fusion cage bone grafting
Simple bone grafting fusion
Degenerative lumbar diseases
Meta-analysis
作者简介
王东平(1993-)男,硕士研究生。研究方向:脊柱骨科;通信作者:晋大祥(1965-)男,博士,主任医师。研究方向:脊柱骨科。
