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减压联合 coflex 棘突间稳定术与传统手术治疗腰椎管狭窄症的比较:系统评价和荟萃分析。

Decompression and coflex interlaminar stabilisation compared with conventional surgical procedures for lumbar spinal stenosis: A systematic review and meta-analysis.

机构信息

Department of Orthopedics, The 5th Central Hospital of Tianjin, China.

出版信息

Int J Surg. 2017 Apr;40:60-67. doi: 10.1016/j.ijsu.2017.02.056. Epub 2017 Feb 22.

Abstract

BACKGROUND

Decompression plus spinal fusion is one of the most common surgeries for the treatment of degenerative spine disease in older adults. However, complications caused by fusion surgery have been reported in some studies. Recently published studies have reported that coflex is a safe and viable option in the selection of instrumentation for spinal stabilisation. Our meta-analysis was conducted to investigate whether decompression and coflex results in better performance for lumbar spinal stenosis (LSS) patients when compared with decompression and fusion surgery.

METHOD

Web of Science, PubMed, Embase, and the Cochrane Library were comprehensively searched. Ten studies that compared coflex with fusion surgery were included in our meta-analysis. The PRISMA guidelines and Cochrane Handbook were applied to assess the quality of the results published in all included studies to ensure that the results of our meta-analysis were reliable and veritable.

RESULTS

The results of our meta-analysis showed that decompression and coflex was more effective than the control procedure in terms of the Oswestry Disability Index (ODI), length of hospital stay (LOS) and blood loss. However, no significant difference was found in visual analogue scale (VAS) and major device-related complications.

CONCLUSIONS

Compared with conventional decompression plus fusion surgery, coflex was not inferior in terms of functional clinical outcomes, including ODI and VAS pain score. Moreover, coflex showed less blood loss, shorter LOS and similar device-related complications compared to decompression plus fusion surgery. Therefore, the coflex interlaminar stabilisation device was found to be safe and effective compared to decompression plus fusion for the treatment of LSS.

摘要

背景

减压加融合术是治疗老年人退行性脊柱疾病最常用的手术之一。然而,一些研究报告了融合手术引起的并发症。最近发表的研究报告称,Coflex 是脊柱稳定器械选择的一种安全可行的选择。我们的荟萃分析旨在研究与减压加融合手术相比,减压加 Coflex 是否能为腰椎管狭窄症(LSS)患者带来更好的疗效。

方法

我们全面检索了 Web of Science、PubMed、Embase 和 Cochrane 图书馆。我们的荟萃分析纳入了 10 项比较 Coflex 与融合手术的研究。我们应用 PRISMA 指南和 Cochrane 手册评估了所有纳入研究中发表结果的质量,以确保我们的荟萃分析结果是可靠和可信的。

结果

荟萃分析结果表明,与对照组相比,减压加 Coflex 在 Oswestry 功能障碍指数(ODI)、住院时间(LOS)和出血量方面更有效。然而,在视觉模拟量表(VAS)和主要器械相关并发症方面没有发现显著差异。

结论

与传统的减压加融合手术相比,Coflex 在功能临床结果方面并不逊色,包括 ODI 和 VAS 疼痛评分。此外,与减压加融合手术相比,Coflex 显示出更少的出血量、更短的 LOS 和相似的器械相关并发症。因此,与减压加融合治疗 LSS 相比,Coflex 椎间层稳定装置被发现是安全有效的。

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