《中国康复理论与实践》

《中国康复理论与实践》 ›› 2012, Vol. 18 ›› Issue (5): 440-443.

• 论文 • 上一篇    下一篇

短节段椎弓根钉内固定结合经伤椎椎体强化治疗胸腰椎骨折临床疗效的Meta 分析

李想，洪毅，唐和虎，张军卫，白金柱，姜树东，王方永，陈世铮   

  1. 1.首都医科大学康复医学院，北京市 100068；2.中国康复研究中心北京博爱医院脊柱脊髓外科，北京市 100068。
  • 收稿日期:2012-03-05 修回日期:1900-01-01 出版日期:2012-05-25 发布日期:2012-05-25

Short-segment Pedicle Instrumentation with Intravertebral Augmentation in Management of Thoracolumbar Fractures: Meta-analysis of Complications

LI Xiang, HONG Yi, TANG He-hu, et al.   

  1. Department of Spine and Spinal Cord Surgery, Capital Medical UniversitySchool of Rehabilitation Medicine, Beijing Bo'ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China
  • Received:2012-03-05 Revised:1900-01-01 Published:2012-05-25 Online:2012-05-25

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被引次数

44

摘要： 目的对经伤椎椎体强化技术(包括经椎弓根植骨、经伤椎椎体内融合器技术以及伤椎椎体成形技术)是否可降低胸腰椎骨折短节段椎弓根钉内固定术后矫正度数的丢失和内固定断裂的发生率进行系统评价。方法检索MEDLINE、EMBASE、中国生物医学数据库，手工检索中文相关杂志。收集所有采用后路短节段椎弓根钉内固定结合经伤椎椎体强化技术治疗胸腰椎骨折的实验性研究(随机对照研究、非随机对照研究)和观察性研究(队列研究、病例对照研究)，并对纳入研究的方法学质量进行评估。利用Cochrane 协作网提供的RevMan 5.0.18 软件进行统计学分析。结果共纳入符合入选标准的文献8 篇，包括英文文献7 篇，中文文献1 篇。其中随机对照研究1 篇，观察性研究7 篇。共包括442 例患者，其中经伤椎椎体强化组包含216 例患者，无经伤椎椎体强化组包含226 例患者。方法学质量评价结果显示，1 篇随机对照研究为高质量，7 篇观察性研究中4 篇为高质量，3 篇为低质量。Meta 分析结果显示，经伤椎椎体强化组与无经伤椎椎体强化组在术后矫正度数丢失和内固定失败发生率方面均无显著性差异。结论经伤椎椎体强化并不能降低胸腰椎骨折短节段椎弓根钉内固定术后矫正度数的丢失和内固定失败的发生率。

关键词: 胸腰椎骨折, 经椎弓根植骨, 椎体成形, 并发症, 系统评价

Abstract: Objective To evaluate the efficacy of intravertebral augmentation which including transpedicular bone graft, transpediclebody augmenter and vertebroplasty in preventing the correction loss and implant failure of short-segment pedicle instrumentation for thoracolumbarfractures through meta-analysis. Methods Experimental studies (randomized controlled trails, non-randomized controlled trails)and observational studies (cohort studies, case control studies) related with application of posterior short-segment pedicle instrumentationwith intravertebral augmentation for thoracolumbar fractures were searched from Pubmed, EMBASE and CNKI according to the inclusionand exclusion criteria, and hand-searched in Chinese and English journals. RevMan 5.0.18 provided by Cochrane was used to analyse the data.Results 1 randomized controlled trail and 7 observational studies were included. There were 442 patients, in which 216 patients werewith and 226 patients without intravertebral augmentation. There was no significant difference in correction loss and risk of implant failurebetween these two groups. Conclusion Intravertebral augmentation does little about the risk of correction loss and implant failure associatedwith posterior short-segment pedicle instrumention for patients with thoraculumbar fractures.

Key words: thoracolumbar fractures, transpediclualr bone graft, vertebraplasty, complications, meta-analysis