经椎弓根动态非融合技术治疗单节段腰椎退行性变疗效的Meta分析

A meta-analysis of the efficacy of transpedicle dynamic non-fusion techniques in the treatment of single-segment lumbar degeneration

目的 通过Meta分析比较经椎弓根动态非融合术和传统椎间融合术在治疗单节段腰椎退行性变疾病中的临床疗效。方法 计算机检索Pub Med、Embase及Cochrane library 3个数据库,由两名研究者对检索到的文献进行纳入与排除,评价文献质量后提取所需要的数据,应用Review Manager 5.3软件进行Meta分析。结果 共筛选出10篇文献,纳入539例患者,其中动态非融合组312例,椎间融合组227例。Meta分析结果显示,动态非融合组与椎间融合组在术后腰椎JOA、腰背痛VAS、下肢痛VAS、ODI上的差异均无统计学意义(P>0.05);两组术式对手术上位相邻节段ROM的影响差异具有统计学意义(MD=-1.65,95%CI:-2.92--0.38,P=0.01),而在手术下位相邻节段ROM差异无统计学意义(MD=0.55,95%CI:-1.19-2.30,P=0.54)。结论 经椎弓根动态非融合术可同样改善患者临床症状,提高手术疗效,但对保护手术相邻节段、预防退变短期疗效并不明显,需长期随访。

Objective To compare the clinical efficacy of transpedicular dynamic non-fusion and traditional interbody fusion technique in the treatment of single segment lumbar degenerative diseases.Methods PubMed,EMBASE and Cochrane library databases were searched,Two researchers included and excluded the retrieved literature,evaluated the quality,extracted the required data,sorted them into tables,and analyzed the data with Review Manager 5.3 software.Results A total of 10 literatures were included in the study,539 patients,including 312 cases in the dynamic non-fusion group and 227 cases in the intervertebral fusion group,The results of meta-analysis showed that the differences in postoperative lumbar JOA,low back pain VAS,lower limb pain vas and ODI between the two groups had no statistical significance;There was significant statistical difference between the two surgical methods on the ROM of upper adjacent segments(MD=-1.65,95%CI:-2.92-0.38,P=0.01),However,there was no significant statistical difference on the ROM of lower adjacent segments(MD=0.55,95%CI:-1.19-2.30,P=0.54).Conclusion Transpedicular dynamic non fusion can also improve the clinical symptoms of patients and improve the surgical efficacy,but the short-term effect on protecting adjacent segments and preventing degeneration is not obvious,which needs further long-term follow-up.