摘要
背景:相邻2个节段的脊髓型颈椎病主要有椎间盘切除植骨融合钢板内固定和椎体次全切除植骨融合钢板内固定两种方式,如何选择存在争议。目的:比较椎间盘切除植骨融合内固定与椎体次全切除植骨融合内固定两种治疗方法对相邻2个节段脊髓型颈椎病治疗后生物力学特性的影响。方法:计算机检索Cochrane Library(2011年第4期)、PubMed(1966/2011-11)、EMBASE(1974/2011-11)、CBM(1978/2011-11)、CNKI(1994/2011-11)、和万方数据库(1997/2011-11),文献语种限为中文和英文。全面收集椎间盘切除植骨融合内固定与椎体次全切除植骨融合内固定2种方法治疗相邻2个节段的脊髓型颈椎病的对照研究,由2个研究者独立评价文献,使用Cochrane协作网提供的软件Revman5.1进行Meta分析。结果与结论:最终纳入分析的研究5个,共382例患者,其中椎间盘切除植骨融合内固定组201例,椎体次全切除植骨融合内固定组181例。Meta分析的结果显示:在手术时间、出血量及术后颈椎曲度方面,椎间盘切除植骨融合内固定组与椎体次全切除植骨融合内固定组差异有显著性意义(P<0.05),而神经功能恢复情况、融合率及并发症方面,两组差异无显著性意义(P>0.05)。对于相邻2个节段脊髓型颈椎病的手术治疗,椎间盘切除植骨融合内固定较椎体次全切除植骨融合内固定具有手术时间短,出血少,术后颈椎矫形较好的优点,而神经功能恢复情况、融合率及并发症与椎体次全切除植骨融合内固定接近。
BACKGROUND: There are two main ways for cervical spondylotic myelopathy (CSM) in anterior approaches, one is anterior cervical discectomy with fusion (ACDF) and the other is anterior cervical corpectomy with fusion (ACCF). The optimal surgical strategy remains controversial for two-level CSM OBJECTIVE: To compare the clinical effects between ACDF and ACCF in treating two-level CSM METHODS: A computer-based online search of Cochrane Library (issue 4, 2011), PubMed database (1966/2011 11 ), EMBASE database (1974/2011 - 11 ), CBM database (1978/2011 11 ), CNKI database (1994/2011 11 ) and Wanfang database (1997/2010-11) was preformed for literatures in English and Chinese. All controlled studies of ACDF and ACCF for the treatment of two-level CSM were identified. Two reviewers assessed the trials and extracted data independently. Meta analysis was conducted with the Revman 5.1 software provided by Cochrane collaboration. RESULTS AND CONCLUSION: A total of 382 cases in 5 controlled trials were included. Totally 201 patients were in the ACDF group and 181 patients were in the ACCF group. The results of Meta analysis showed that there were statistically significant differences in operation time, bleeding amount and cervical lordosis between ACDF group and ACCF group (P 〈 0.05), but there was no significant difference in the function recovery rate of spinal cord, fusion rate and complications between two groups (P 〉 0.05). Compared with ACCF, ACDF had the advantages of a shorter operation time, less bleeding and better cervical lordosis for two-level CSM. But there was no obvious difference in the function recovery rate of spinal cord, fusion rate and complications.
出处
《中国组织工程研究》
CAS
CSCD
2012年第17期3134-3138,共5页
Chinese Journal of Tissue Engineering Research