Ye Yong-ping, Chen Dang, Xu Hao
Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou, 350025, China,
Eur Spine J. 2014 Sep;23(9):1918-26. doi: 10.1007/s00586-014-3453-1. Epub 2014 Jul 14.
This meta-analysis compared whether fusion with or without instrumentation to treat this disease differed with respect to patient-centered outcomes.
Medline, Cochrane, EMBASE, Google Scholar data bases were searched for randomized control trials that investigated patients with severe chronic lower back pain resulting from localized lumbar or lumbosacral instability caused by either isthmic spondylolisthesis or degenerative spondylolisthesis. Included randomized studies reported quantitative outcomes for low back pain and functional recovery. The primary outcome was the improvement of function and the secondary outcomes were the improvement of pain, patients' satisfactory level, and the fusion rate.
A significantly lower function change in patients with instrumented compared with non-instrumented from baseline (pooled standardized mean difference; -1.02 (95% CI -1.76 to -0.27); Z -2.67; (P = 0.008)]. There was no significant pain change for patients with instrumented compared with that of non-instrumented from baseline [pooled standardized mean difference; -0.07 (95% CI -1.25 to 1.12); Z -0.11; (P = 0.913)]. There was no significant difference in satisfactory level for patients with instrumented compared with that of non-instrumented [pooled OR; 2.36 (95% CI 0.91-6.11); Z 1.76; (P = 0.078)]. There was significantly higher fusion rate for patients with instrumented compared with that of non-instrumented [pooled OR; 3.28 (95% CI 2.22-4.85); Z 5.96; (P < 0.001)].
This meta-analysis found that inclusion of fusion surgery with instrumentation provided no benefit as evaluated by patient-reported outcomes in patients with lumbar spondylolisthesis.
Not applicable.
本荟萃分析比较了采用或不采用器械辅助融合治疗该疾病在以患者为中心的结局方面是否存在差异。
检索了Medline、Cochrane、EMBASE、谷歌学术数据库，以查找针对因峡部裂性脊椎滑脱或退变性脊椎滑脱导致的局限性腰椎或腰骶部不稳引起的严重慢性下腰痛患者的随机对照试验。纳入的随机研究报告了腰痛和功能恢复的定量结局。主要结局是功能改善，次要结局是疼痛改善、患者满意度水平和融合率。
与未采用器械辅助的患者相比，采用器械辅助的患者从基线开始的功能变化显著更低（合并标准化均数差；-1.02（95%可信区间-1.76至-0.27）；Z=-2.67；（P=0.008）]。与未采用器械辅助的患者相比，采用器械辅助的患者从基线开始的疼痛变化无显著差异[合并标准化均数差；-0.07（95%可信区间-1.25至1.12）；Z=-0.11；（P=0.913）]。与未采用器械辅助的患者相比，采用器械辅助的患者在满意度水平上无显著差异[合并比值比；2.36（95%可信区间0.91-6.11）；Z=1.76；（P=0.078）]。与未采用器械辅助的患者相比，采用器械辅助的患者的融合率显著更高[合并比值比；3.28（95%可信区间2.22-4.85）；Z=5.96；（P<0.001）]。
本荟萃分析发现，对于腰椎滑脱患者，根据患者报告的结局评估，采用器械辅助的融合手术并无益处。
不适用。
