微创与开放经椎间孔椎体间融合治疗腰椎滑脱的Meta分析

Meta-analysis of Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for Lumbar Spondylolisthesis

目的:探讨微创与开放经椎间孔椎体间融合治疗腰椎滑脱效果。方法:基于中文、英文数据库,利用计算机自动完成中国知网、万方、维普、英文PubMed、EMbase数据库检索;手动完成综述、会议文献检索。检索词为"腰椎滑脱""微创手术""开放经椎间孔椎体间融合""临床效果""安全性"等,纳入符合上述要求的文献,检索词为2020年1月。将获得的文献由笔者所在医院2位评价员完成文献数量与质量的核对、验证,并完成Meta分析。结果:初步筛选获得文献303篇,运用Note Express去重后获得文献229篇,阅读文献摘要、题目排除77篇。对剩余的152篇文献进行阅读,结合纳入、排除标准,排除146篇,最终纳入6篇文献,其中中文文献5篇,英文文献1篇。微创与开放经椎间孔椎体间融合治疗腰椎滑脱效果良好[χ~2=3 146.77,df=7(P<0.000 01),I^2=100%,Z=0.03(P=0.97)]。微创经椎间孔椎体间融合治疗腰椎滑脱安全性较高[χ~2=77.64,df=3(P<0.000 01),I^2=96.0%,Z=4.72(P<0.000 01)]。结论:将微创经椎间孔椎体间融合用于腰椎滑脱患者中具有手术创伤较小的特点,能获得良好的治疗效果,安全性较高,值得推广应用。

Objective:To explore the effects of minimally invasive and open transforaminal lumbar interbody fusion in the treatment of lumbar spondylolisthesis.Method:Based on the Chinese and English databases,the retrieval of China HowNet,Wanfang,Weipu,English PubMed,and EMbase databases were completed by the computer,and the retrieval of review and conference literature were completed manually.And the search terms were lumbar spondylolisthesis,minimally invasive surgery,open transforaminal lumbar interbody fusion,clinical effect,safety,etc.,the literatures meeting the above requirements were included,and the search term was January 2020.The obtained literatures were checked and verified by the two evaluators of our hospital,and the Meta-analysis was completed.Result:A total of 303 literatures were obtained through preliminary screening,229 literatures were obtained after deduplication using Note Express,and 77 literatures were excluded from reading the abstracts and titles.Read the remaining 152 literatures,combined with the inclusion and exclusion criteria,excluded 146 literatures,and finally included 6 literatures,with 5 Chinese literatures and 1 English literatures.Minimally invasive and open transforaminal lumbar interbody fusion had a good effect in the treatment of lumbar spondylolisthesis[χ~2=3 146.77,df=7 (P<0.000 01),I^2=100%,Z=0.03 (P=0.97)].Minimally invasive transforaminal lumbar interbody fusion had a high safety in the treatment of lumbar spondylolisthesis[χ~2=77.64,df=3 (P<0.000 01),I^2=96.0%,Z=4.72 (P<0.000 01)].Conclusion:Minimally invasive transforaminal lumbar interbody fusion is used in patients with lumbar spondylolisthesis has the characteristic of less surgical trauma,which can obtain good therapeutic effect,high safety,and is worthy of popularization and application.