微创对比传统开放椎弓根螺钉内固定术对上位椎间关节影响的Meta分析

Comparison of Superior-Level Facet Joint Violations during Open and Percutaneous Pedicle Screw Placement: A Meta-Analysis

目的:系统评价微创对比开放固定技术治疗腰椎骨折对上位椎间关节的影响。方法:计算机检索Pub Med、EMbase、The Cochrane Library、CBM、CNKI、VIP和Wan Fang Data,并手工检索相关期刊,全面收集开放对比微创固定技术导致上位椎间关节破坏的相关临床研究,检索时限均为建库至2017年9月。由2位评价员按照纳入与排除标准独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Stata 12.0软件进行Meta分析。结果:共纳入6篇文献,共1 120例患者。Meta分析结果显示:经皮固定与开放手术相比,两者一级关节破坏[OR=0.38,95%CI(0.24,1.73),P=0.38]、二级关节破坏[OR=0.41,95%CI(0.09,1.84),P=0.24],总的关节破坏[OR=0.85,95%CI(0.42,1.72),P=0.66]差异均无统计学意义。结论:两种术式对上位椎间关节破坏没有差异。受纳入研究数量和质量的限制,上述结论仍有待更多高质量的研究予以验证。

Objective:To perform a systematic review the impact on the Superior Intervertebral Joint using Minimal Invasive and Open Pedicle Screw Fixation with meta-analysis.Methods:The databases such as PubMed、EMbase、The Cochrane Library、CBM、CNKI、VIP and WanFang Data were searched from inception to September,2017.Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data and assessed the risk of bias of included studies.Meta-analysis was performed using Stata 12.0 software.Results:A total of six studies involving 1 120 patients were included.The results of meta-analyses indicated that there was no significant difference in the Level 1 articular damage[OR=0.38,95%CI(0.24,1.73),=0.38],level 2 articular damage[OR=0.41,95%CI(0.09,1.84),=0.24]and the total articular damage[OR=0.85,95%CI(0.42,1.72),=0.66]between the minimal invasive and open pedicle screw fixation.Conclusion:There was no significant difference between the minimal invasive and open pedicle screw fixation.Due to the limited quantity of the included studies,more high quality studies are needed to verify the above conclusion.