CAJ | 학술논문

目的通过分析国内外相关文献,评价伤椎置钉短节段内固定和传统短节段内固定治疗胸腰椎骨折的临床疗效. 方法计算机检索1990年1月-2012年12月中国知网数据库、Pubmed、Cochrane系统评价资料库、Cochrane临床对照试验中心数据库等中英文数据库,并同时采用手工检索,按照既定的纳入和排除标准查找伤椎置钉短节段内固定和传统内固定比较的相关文献.按照非RCT的方法学指数(methodological index for non-randomized studies,MINORS)对纳入的文献进行质量评价,使用RevMan 5.2进行Meta分析的相关计算. 结果共纳入13篇文献,患者728例,其中传统短节段内固定441例,传统短节段内固定+伤椎置钉287例.伤椎置钉短节段内固定与传统短节段内固定比较,在手术前后Cobb角、术后伤椎椎体前缘高度、长期随访Cobb角和伤椎椎体前缘高度方面差异均有统计学意义(P均＜0.05). 结论与传统短节段内固定相比,伤椎置钉短节段内固定可以更好矫正Cobb角并且长期疗效较好,但传统短节段内固定在恢复和维持伤椎高度上优于伤椎置钉短节段内固定.
목적 통과분석국내외상관문헌,평개상추치정단절단내고정화전통단절단내고정치료흉요추골절적림상료효. 방법 계산궤검색1990년1월-2012년12월중국지망수거고、Pubmed、Cochrane계통평개자료고、Cochrane림상대조시험중심수거고등중영문수거고,병동시채용수공검색,안조기정적납입화배제표준사조상추치정단절단내고정화전통내고정비교적상관문헌.안조비RCT적방법학지수(methodological index for non-randomized studies,MINORS)대납입적문헌진행질량평개,사용RevMan 5.2진행Meta분석적상관계산. 결과 공납입13편문헌,환자728례,기중전통단절단내고정441례,전통단절단내고정+상추치정287례.상추치정단절단내고정여전통단절단내고정비교,재수술전후Cobb각、술후상추추체전연고도、장기수방Cobb각화상추추체전연고도방면차이균유통계학의의(P균＜0.05). 결론 여전통단절단내고정상비,상추치정단절단내고정가이경호교정Cobb각병차장기료효교호,단전통단절단내고정재회복화유지상추고도상우우상추치정단절단내고정.
Objective To compare the clinical results of transvertebral versus conventional shortsegmental fixation in treatment of thoracolumbar fractures by referring to related literatures at home and abroad.Methods Based on the established inclusion and exclusion criteria,studies of transvertebral versus conventional short-segmental fixation for thoracolumbar fractures were electronically searched from January 1990 to December 2012 using CNKI,PubMed,Cochrane Database of Systematic Reviews,and Cochrane Central Register of Controlled Trials.A manual search was performed as well.A quality assessment of the included studies was performed using the methodological index for non-randomized studies (MINORS).Meta analysis was carried out using RevMan 5.2 software.Results Thirteen papers involving 728 cases,of whom 441 had conventional short-segmental fixation and 287 conventional short-segmental fixation plus transvertebral insertion were included.The two methods revealed statistical significances in aspects of Cobb' s angles and anterior vertebral body height before and after operation and at the long-term follow-up.Conclusion Transvertebral short-segmental fixation enables more correction of Cobb' s angle and better late effect compared with the conventional fixation method,but the latter is superior in restoration and maintenance of vertebral height.