CAJ | 학술논문

目的收集并分析有关颈椎间盘置换术与颈前路减压椎间融合术(anterior cervical dis-cectomy and fusion,ACDF)术后疗效比较的文献,对颈椎间盘置换术和ACDF术后疼痛及残障指数进行Meta分析.方法检索Medline(1966年1月至2008年11月)、Embase(1966年1月至2008年11月)、AMED(1985年1月至2008年11月)和Cochrane Library等数据库中关于颈椎间盘置换术和ACDF术后疗效比较的随机对照研究,纳入符合标准的文献,提取相关数据输入Review Manager4.2软件进行统计学分析.臂部疼痛及颈部疼痛的视觉模拟评分(visual analogue scale,VAS)、颈部功能残障指数(neckdisability index,NDI)均采用权重均差(weighted mean difference,WMD)进行评价.结果共4篇文献符合纳入标准,经改良Jadad评分判定均为高质最研究.共纳入213例,干预组(颈椎间盘置换组)和对照组(ACDF组)术后6周臂部疼痛VAS合并WMD为-2.91[95%置信区间(-4.19,-1.62),P<0.05],术后6个月合并WMD值为-2.67[95%置信区间(-4.02,-1.33),P<0.05].干预组和对照组术后6周NDI合并WMD值为-11.93[95%置信区间(-15.66,-8.19),P<0.05],术后6个月合并WMD值为-11.2[95%置信区间(-14.74,-7.69),P<0.05].结论颈椎间盘置换术后6周和6个月时患者臂部疼痛程度低于ACDF;颈椎间盘置换术后6周和6个月患者颈部功能恢复程度高于ACDF.
목적 수집병분석유관경추간반치환술여경전로감압추간융합술(anterior cervical dis-cectomy and fusion,ACDF)술후료효비교적문헌,대경추간반치환술화ACDF술후동통급잔장지수진행Meta분석.방법 검색Medline(1966년1월지2008년11월)、Embase(1966년1월지2008년11월)、AMED(1985년1월지2008년11월)화Cochrane Library등수거고중관우경추간반치환술화ACDF술후료효비교적수궤대조연구,납입부합표준적문헌,제취상관수거수입Review Manager4.2연건진행통계학분석.비부동통급경부동통적시각모의평분(visual analogue scale,VAS)、경부공능잔장지수(neckdisability index,NDI)균채용권중균차(weighted mean difference,WMD)진행평개.결과공4편문헌부합납입표준,경개량Jadad평분판정균위고질최연구.공납입213례,간예조(경추간반치환조)화대조조(ACDF조)술후6주비부동통VAS합병WMD위-2.91[95%치신구간(-4.19,-1.62),P<0.05],술후6개월합병WMD치위-2.67[95%치신구간(-4.02,-1.33),P<0.05].간예조화대조조술후6주NDI합병WMD치위-11.93[95%치신구간(-15.66,-8.19),P<0.05],술후6개월합병WMD치위-11.2[95%치신구간(-14.74,-7.69),P<0.05].결론 경추간반치환술후6주화6개월시환자비부동통정도저우ACDF;경추간반치환술후6주화6개월환자경부공능회복정도고우ACDF.
Objective To evaluate the postoperative pain and neck function of patients who under-went cervical disc replacement or anterior cervical discectomy and fusion (ACDF) by Meta-analysis. Meth-otis In Medline (1966.1-2008.11), Embase (1966.1-2008.11), AMED (1985.1-2008.11) and Cochrane Li-brary, the randomized controlled trails about the comparison between cervical disc replacement and ACDF were collected. Then extracted the data of arm pain visual analogue scale (VAS), neck pain VAS and neck disability index (NDI) in these researches and made a Meta-analysis using Review Manager 4.2. Weighted mean difference (WMD) was selected for the evaluation of the overall effect. Results Four articles were ac-cepted in our Meta-analysis and all of them were high quality researches identified by modified Jadad Scale.Altogether, 213 patients were included. The combined WMD of arm pain VAS was -2.91[95% confidence in-terval (CI) (-4.19,-1.62), P< 0.05] 6 weeks after surgery and -2.67[95%CI (-4.02,-1.33), P<0.05] 6 months after surgery. The combined WMD of NDI was -11.93[95%CI (-15.66,-8.19), P< 0.05] 6 weeks after surgery and -11.2[95%CI (-14.74,-7.69), P< 0.05] 6 months after surgery. Conclusion The arm pain VAS of treatment group (cervical disc replacement) is lower than that of control group (ACDF) both 6 weeks and 6 months after surgery. The NDI of treatment group is lower than that of control group both 6 weeks and 6 months after surgery.