中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
9期
1404-1415
,共12页
植入物%脊柱植入物%计算机辅助导航%椎弓根螺钉%置钉精度%腰椎%Meta分析
植入物%脊柱植入物%計算機輔助導航%椎弓根螺釘%置釘精度%腰椎%Meta分析
식입물%척주식입물%계산궤보조도항%추궁근라정%치정정도%요추%Meta분석
lumbar vertebrae%internal fixators%computer systems%spine%meta-analysis
背景：计算机辅助导航技术在脊柱外科领域已得到广泛应用，但目前仍缺乏在腰椎椎弓根螺钉内固定术中应用该技术的系统评价。<br> 目的：评价计算机辅助导航技术在腰椎椎弓根螺钉固定过程中的价值。<br> 方法：通过计算机检索PubMed、Embase和中国期刊全文数据库CNKI等中英文数据库以及手工检索有关计算机辅助导航下腰椎椎弓根螺钉置入中的相关研究和文献，将计算机辅助导航置钉与传统置钉的置钉精度、术中出血量、手术用时、置钉相关并发症发生率等进行比较。<br> 结果与结论：共纳入7篇符合纳入标准的近期文献，累计病例784例，置入腰椎椎弓根螺钉4101枚。Meta分析表明，计算机辅助导航下置入腰椎椎弓根螺钉的置钉失误率[RR=0.44，95%CI：(0.27，0.69)，P=0.0004]与内固定中出血量[WMD=-172.40，95%CI：(-246.26，-98.53)，P<0.00001]与传统置钉方式相比差异有显著性意义，而手术用时[WMD=-31.45，95%CI：(-85.56，22.66)，P=0.25]与并发症发生率[RR=0.41，95%CI：(0.12，1.41)，P=0.16]则差异无显著性意义。计算机辅助导航技术在腰椎椎弓根螺钉固定术中的应用，可以提高置钉精度，但是否能改善患者内固定后的远期预后，目前仍需进一步研究。
揹景：計算機輔助導航技術在脊柱外科領域已得到廣汎應用，但目前仍缺乏在腰椎椎弓根螺釘內固定術中應用該技術的繫統評價。<br> 目的：評價計算機輔助導航技術在腰椎椎弓根螺釘固定過程中的價值。<br> 方法：通過計算機檢索PubMed、Embase和中國期刊全文數據庫CNKI等中英文數據庫以及手工檢索有關計算機輔助導航下腰椎椎弓根螺釘置入中的相關研究和文獻，將計算機輔助導航置釘與傳統置釘的置釘精度、術中齣血量、手術用時、置釘相關併髮癥髮生率等進行比較。<br> 結果與結論：共納入7篇符閤納入標準的近期文獻，纍計病例784例，置入腰椎椎弓根螺釘4101枚。Meta分析錶明，計算機輔助導航下置入腰椎椎弓根螺釘的置釘失誤率[RR=0.44，95%CI：(0.27，0.69)，P=0.0004]與內固定中齣血量[WMD=-172.40，95%CI：(-246.26，-98.53)，P<0.00001]與傳統置釘方式相比差異有顯著性意義，而手術用時[WMD=-31.45，95%CI：(-85.56，22.66)，P=0.25]與併髮癥髮生率[RR=0.41，95%CI：(0.12，1.41)，P=0.16]則差異無顯著性意義。計算機輔助導航技術在腰椎椎弓根螺釘固定術中的應用，可以提高置釘精度，但是否能改善患者內固定後的遠期預後，目前仍需進一步研究。
배경：계산궤보조도항기술재척주외과영역이득도엄범응용，단목전잉결핍재요추추궁근라정내고정술중응용해기술적계통평개。<br> 목적：평개계산궤보조도항기술재요추추궁근라정고정과정중적개치。<br> 방법：통과계산궤검색PubMed、Embase화중국기간전문수거고CNKI등중영문수거고이급수공검색유관계산궤보조도항하요추추궁근라정치입중적상관연구화문헌，장계산궤보조도항치정여전통치정적치정정도、술중출혈량、수술용시、치정상관병발증발생솔등진행비교。<br> 결과여결론：공납입7편부합납입표준적근기문헌，루계병례784례，치입요추추궁근라정4101매。Meta분석표명，계산궤보조도항하치입요추추궁근라정적치정실오솔[RR=0.44，95%CI：(0.27，0.69)，P=0.0004]여내고정중출혈량[WMD=-172.40，95%CI：(-246.26，-98.53)，P<0.00001]여전통치정방식상비차이유현저성의의，이수술용시[WMD=-31.45，95%CI：(-85.56，22.66)，P=0.25]여병발증발생솔[RR=0.41，95%CI：(0.12，1.41)，P=0.16]칙차이무현저성의의。계산궤보조도항기술재요추추궁근라정고정술중적응용，가이제고치정정도，단시부능개선환자내고정후적원기예후，목전잉수진일보연구。
BACKGROUND:Computer-assisted navigation technique has been widely applied in spinal surgery, but there is stil lack of systematic reviews on this technique in lumbar pedicle screw fixation. <br> OBJECTIVE:To evaluate the application of computer-assisted navigation technique in lumbar pedicle screw fixation. <br> METHODS:Databases such as PubMed, Embase and China journal ful-text database CNKI were searched for articles about computer-assisted navigation in lumbar pedicle screw fixation, and related studies and literatures were hand-searched as wel , and then insertion accuracy, intraoperative blood loss, operative time consumption and rate of insertion-related complications between computer-assisted navigation technique group and conservative technique group were compared. <br> RESULTS AND CONCLUSION:Final y 7 studies which met the inclusion criteria were included with 784 patients and 4 101 lumbar pedicle screws in total. Meta-analysis indicated that malposition rate [relative risk (RR)=0.44, 95%confidence interval (CI):(0.27, 0.69), P=0.000 4] and intraoperative blood loss [weighted mean difference (WMD)=-172.40, 95%CI:(-246.26,-98.53), P<0.000 01] had statistical y significant differences between computer-assisted navigation technique group and conservative insertion group. However, operative time consumption [WMD=-31.45, 95%CI:(-85.56, 22.66), P=0.25] and incidence of complications [RR=0.41, 95%CI:(0.12, 1.41), P=0.16] did not show significant differences between groups. Application of computer-assisted navigation technique in lumbar pedicle screw fixation would improve insertion accuracy. However, further study is stil needed to make clear whether this technique can improve final outcome in post-operative patients.
