摘要
目的:对微创经椎间孔椎体间融合(MIS TLIF)与开放经椎间孔椎体间融合(Open TLIF)技术治疗单节段腰椎滑脱疾病进行Meta分析,以判断2种手术方法的术后效果及临床价值。方法:通过对Pub Med、Embase、Cochrane library、中国期刊全文数据库、中国生物医学数据库、中文科技期刊全文数据库等进行系统检索;检索发表于2014年3月以前,以单节段腰椎滑脱疾病为研究对象,采用Rev Man5.2对微创与开放经椎间孔椎间融合手术临床疗效的研究并进行系统分析。分析指标包括:手术持续时间、术中出血量、术中及术后早期并发症、末次随访时融合率。结果:通过初次筛选、二次筛选及再次筛选,本系统分析共纳入8项研究,其中随机对照研究2项,队列研究6项。所纳入的研究患者共866例,其中微创手术组417例,开放手术组449例。与开放经椎间孔椎间融合手术相比,微创手术持续时间、术中及术后早期并发症、末次随访时融合率以及术前的VAS、ODI评分的差异无统计学意义(P>0.05),但是术中出血量、住院天数及末次随访时视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分的差异具有统计学意义(P<0.05)。结论:与Open TLIF相比,MIS TLIF并不会增加手术时间、术中及术后的早期并发症,也不会影响远期的融合率;此外,MIS TLIF在减少患者术中出血量和住院时间的同时可早期缓解术后疼痛与功能恢复,表明MIS TLIF是治疗单节段腰椎滑脱疾病比较理想的手术方式。
Objective：To evaluate postoperative effect and clinical efficacy on minimally invasive transforaminal lumbar interbody fusion （MIS TLIF） and open transforaminal lumbar interbody fusion （Open TLIF） in treatment of one-level lumbar spondylolisthesis diseases. Methods： The papers on one-level lumbar spondylolisthesis diseases published before March 2014 in database of PubMed, Embase, Cochrane library, CNKI, CBM, VIP were systematically retrieved. For controlled trials, prospective cohort study and retrospective cohort study on the comparison between minimally invasive and traditional open transforaminal lumbar interbody fusion in treatment of one-level lumbar spondylolisthesis diseases. Revman 5.2 was used for researching and systematically analyzing the clinical indexes of MIS TLIF and Open TLIF, which include operation time, intraoperative blood loss, intraoperative and postoperative complications and the last follow-up fusion rate. Results： Through the initial screening, secondary screening and further screening, 8 studies （with 2 randomized controlled studies and 6 cohort studies） involving 866 cases were included for the analysis, with 417 subjects in the MIS TLIF group and 449 in the Open TLIF group. The operation time, intraoperative and postoperative complications, the last follow-up fusion rate, preoperative VAS and ODI scores in the MIS TLIF group showed no statistical difference compared with the Open TLIF （P 〉 0.05）; however, intraoperative blood loss, hospital stay, last follow-up ODI and VAS scores showed statistical difference（P 〈 0.05）; Conclusion： Compare with Open TLIF, MIS TLIF did not increase the operative time, intraoperative and postoperative complications, and the long-term rate of fusion. In addition, MIS TLIF can reduce the duration of hospitalization and intraoperative blood loss, and meanwhile, early relieve postoperative pain and help functional recovery. These in- formation indicates that MIS TLIF is an ideal treatment for one-level lumbar spondylolisthesis disease.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2015年第1期131-138,共8页
Journal of Nanjing Medical University(Natural Sciences)
基金
江苏省兴卫工程医学重点人才项目(RC201154)
关键词
微创技术
经椎间孔椎间融合
腰椎滑脱
META分析
minimally invasive technology
transforaminal lumbar interbody fusion
lumbar spondylolisthesis
Meta-analysis
