单纯减压与减压融合治疗腰椎管狭窄临床疗效的meta分析

Decompression alone versus decompression combined with fusion for lumbar spinal stenosis:A meta-analysis of RCTs

目的:系统评价单纯减压和减压融合治疗腰椎滑脱症的临床疗效。方法:检索Pubmed、EMBASE、Cochrane图书馆、CNKI、CBM、万方和维普数据库,检索时间至2018年8月,获取单纯减压和减压融合治疗腰椎管狭窄的随机对照试验(RCTs)。应用RevMan 5.3统计学软件进行分析比较两组患者手术时间、失血量、住院时间、再手术率和随访2年脊柱ODI评分情况。结果:共纳入5篇外文对照研究,包括438例患者;单纯减压组手术时间、住院时间、术中失血量明显低于减压融合组,差异有统计学意义(均P<0.05)。手术效果满意度、ODI评分和再手术率方面,单纯减压和减压融合相比,差异无统计学意义(P>0.05)。结论:单纯减压治疗腰椎管狭窄手术时间短、出血量少,疗效肯定,值得临床推广应用。

Objective: To compare the clinical efficacy between decompression alone and decompression combined with fusion for lumbar spinal stenosis. Methods: Pubmed,EMBASE,Cochrane library,CNKI,Wanfang and VIP database were searched.Randomized controlled trials (RCTs) which compared the clinical outcomes of decompression alone and decompression combined with fusion for lumbar spinal stenosis were included.The meta analysis was performed with RevMan 5.3. Results: There were 5 RCTs involving 438 patients were included in this review.The operation time,hospital days and blood loss in patients who only received the treatment of decompression were superior to those received the combination of decompression and fusion ( P <0.05),whereas no significant difference was noted in the satisfaction rate of operation,ODI score and reoperation rate between the two methods ( P >0.05). Conclusion: Decompression alone has advantages in the treatment of lumbar spinal stenosis,such as shorter operation time,less blood loss and satisfactory efficacy.