中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
13期
2415-2422
,共8页
王银%陈根元%胡龙%萧文耀%王建民
王銀%陳根元%鬍龍%蕭文耀%王建民
왕은%진근원%호룡%소문요%왕건민
骨关节植入物%骨关节植入物循证医学%退行性腰椎疾病%单节段%经椎间孔椎体间融合%微创手术%开放手术%Meta 分析%随机对照%前路椎体间融合术%后路椎体间融合术
骨關節植入物%骨關節植入物循證醫學%退行性腰椎疾病%單節段%經椎間孔椎體間融閤%微創手術%開放手術%Meta 分析%隨機對照%前路椎體間融閤術%後路椎體間融閤術
골관절식입물%골관절식입물순증의학%퇴행성요추질병%단절단%경추간공추체간융합%미창수술%개방수술%Meta 분석%수궤대조%전로추체간융합술%후로추체간융합술
背景:微创经椎间孔椎体间融合技术采用微小切口经可扩张通道进行,与开放经椎间孔椎体间融合技术相比,微创技术视野小,操作更为精细,对周围组织的损伤较小,有利于恢复.
目的:对微创经椎间孔椎体间融合技术与开放经椎间孔椎体间融合技术治疗单节段退行性腰椎疾病的疗效及临床价值进行评价.
方法:检索2005至2012年间 Cochrane library、PubMed、Embase、SCI、中国生物医学文献数据库、中国知网和万方数据库,手工检索相关文献的参考文献及4种中文主要骨科杂志,纳入以单节段退行性腰椎疾病为研究对象,比较微创与开放经椎间孔椎体间融合技术治疗的随机对照试验,前瞻性队列研究及回顾性队列研究,严格评价纳入研究的方法学质量并提取资料,用 Cochrane 协作网提供的Revman5.1进行 Meta 分析.
结果与结论:经过筛选纳入7个研究(856例患者).7个研究圴选用手术时间作为观察指标,结果显示微创手术的手术操作时间与开放手术比较差异无显著性意义(P=0.11);6个研究选用术中出血量作为观察指标,结果显示微创手术的术中出血量明显少于开放手术(P <0.00001);2个研究选用手术后下地时间作为观察指标,结果显示微创手术的术后下地时间短于开放手术(P <0.00001);6个研究选用术中及术后早期并发症作为观察指标,结果显示微创手术的并发症与开放手术比较差异无显著性意义(P=0.75);3个研究选用融合率作为观察指标,结果显示微创手术的术后融合率与开放手术比较差异无显著性意义(P=1.00).提示微创经椎间孔椎体间融合技术是治疗单节段退行性腰椎疾病较理想的方式.
揹景:微創經椎間孔椎體間融閤技術採用微小切口經可擴張通道進行,與開放經椎間孔椎體間融閤技術相比,微創技術視野小,操作更為精細,對週圍組織的損傷較小,有利于恢複.
目的:對微創經椎間孔椎體間融閤技術與開放經椎間孔椎體間融閤技術治療單節段退行性腰椎疾病的療效及臨床價值進行評價.
方法:檢索2005至2012年間 Cochrane library、PubMed、Embase、SCI、中國生物醫學文獻數據庫、中國知網和萬方數據庫,手工檢索相關文獻的參攷文獻及4種中文主要骨科雜誌,納入以單節段退行性腰椎疾病為研究對象,比較微創與開放經椎間孔椎體間融閤技術治療的隨機對照試驗,前瞻性隊列研究及迴顧性隊列研究,嚴格評價納入研究的方法學質量併提取資料,用 Cochrane 協作網提供的Revman5.1進行 Meta 分析.
結果與結論:經過篩選納入7箇研究(856例患者).7箇研究圴選用手術時間作為觀察指標,結果顯示微創手術的手術操作時間與開放手術比較差異無顯著性意義(P=0.11);6箇研究選用術中齣血量作為觀察指標,結果顯示微創手術的術中齣血量明顯少于開放手術(P <0.00001);2箇研究選用手術後下地時間作為觀察指標,結果顯示微創手術的術後下地時間短于開放手術(P <0.00001);6箇研究選用術中及術後早期併髮癥作為觀察指標,結果顯示微創手術的併髮癥與開放手術比較差異無顯著性意義(P=0.75);3箇研究選用融閤率作為觀察指標,結果顯示微創手術的術後融閤率與開放手術比較差異無顯著性意義(P=1.00).提示微創經椎間孔椎體間融閤技術是治療單節段退行性腰椎疾病較理想的方式.
배경:미창경추간공추체간융합기술채용미소절구경가확장통도진행,여개방경추간공추체간융합기술상비,미창기술시야소,조작경위정세,대주위조직적손상교소,유리우회복.
목적:대미창경추간공추체간융합기술여개방경추간공추체간융합기술치료단절단퇴행성요추질병적료효급림상개치진행평개.
방법:검색2005지2012년간 Cochrane library、PubMed、Embase、SCI、중국생물의학문헌수거고、중국지망화만방수거고,수공검색상관문헌적삼고문헌급4충중문주요골과잡지,납입이단절단퇴행성요추질병위연구대상,비교미창여개방경추간공추체간융합기술치료적수궤대조시험,전첨성대렬연구급회고성대렬연구,엄격평개납입연구적방법학질량병제취자료,용 Cochrane 협작망제공적Revman5.1진행 Meta 분석.
결과여결론:경과사선납입7개연구(856례환자).7개연구작선용수술시간작위관찰지표,결과현시미창수술적수술조작시간여개방수술비교차이무현저성의의(P=0.11);6개연구선용술중출혈량작위관찰지표,결과현시미창수술적술중출혈량명현소우개방수술(P <0.00001);2개연구선용수술후하지시간작위관찰지표,결과현시미창수술적술후하지시간단우개방수술(P <0.00001);6개연구선용술중급술후조기병발증작위관찰지표,결과현시미창수술적병발증여개방수술비교차이무현저성의의(P=0.75);3개연구선용융합솔작위관찰지표,결과현시미창수술적술후융합솔여개방수술비교차이무현저성의의(P=1.00).제시미창경추간공추체간융합기술시치료단절단퇴행성요추질병교이상적방식.
@@@@BACKGROUND: Minimal y invasive transforaminal lumbar interbody fusion can be performed through a tiny incision using a expandable channel. Compared with open transforaminal lumbar interbody fusion, minimal y invasive transforaminal lumbar interbody fusion has smal er surgical field, more elaborate operation and less injury to the surrounding tissue which is conductive to accelerate overal recovery. @@@@OBJECTIVE: To evaluate the surgical outcome and clinicaI value between minimal y invasive and open transforaminal lumbar interbody fusion in treatment of single segment degenerative lumbar disease. @@@@METHODS: The Cochrane library, PubMed database, Embase database, SCI database, CNKI database, Wanfang database and Chinese Biomedical database were searched for control ed trials, prospective cohort study and retrospective cohort study on the comparison between minimal y invasive and open transforaminal lumbar interbody fusion in treatment of degenerative lumbar disease. Furthermore, we also manual y searched the relevant references and four Chinese orthopedic journals. Methodology quality of the trials was critical y assessed and the relative data were extracted. Cochrane Col aboration provided Revman 5.1 software was used for Meta-analysis. @@@@RESULTS AND CONCLUSION: Seven studies involving 856 cases were included. Al the studies observed the surgical time, and the results of Meta-analysis showed that there was no statistical y significant difference in the surgical time between minimal y invasive and open transforaminal lumbar interbody fusion (P=0.11); six studies observed the intraoperative blood loss, and the results showed that the intraoperative blood loss of minimal y invasive transforaminal lumbar interbody fusion was significantly less than that of the open transforaminal lumbar interbody fusion (P < 0.000 01); two studies observed the weight bearing time, and the results showed that the weight bearing time after minimal y invasive transforaminal lumbar interbody fusion was shorter than that after open transforaminal lumbar interbody fusion (P < 0.000 01); six studies observed the intraoperative and postoperative complications, and the results showed that there were no significant differences between minimal y invasive and open transforaminal lumbar interbody fusion (P=0.75); three studies observed the fusion rate, and the results showed there was no significant difference between minimal y invasive and open transforaminal lumbar interbody fusion (P=1.00). The results showed that minimal y invasive transforaminal lumbar interbody fusion was the ideal method for the treatment of single segment degenerative lumbar disease.
