Lan Tao, Chen Yang, Hu Shi-Yu, Li Ao-Lin, Yang Xin-Jian
Department of Spine Surgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518035, PR China.
Department of Spine Surgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518035, PR China.
J Orthop Sci. 2017 Sep;22(5):828-833. doi: 10.1016/j.jos.2017.05.014. Epub 2017 Jun 20.
The purpose of this meta-analysis was to compare the efficacy and safety between patients with thoracolumbar burst fracture who underwent posterior fixation alone (non-fusion) and supplemented with fusion.
A comprehensive search of related literature was performed in PubMed, Embase and the Cochrane library. Clinical outcomes (LBOS and VAS), surgical outcomes (operation time, blood loss, hospital stay and perioperative complications), and radiographic outcomes (kyphotic angle, decreased vertebral body height and segmental motion) were assessed in the meta-analysis. Data analysis was conducted with RevMan 5.3 software.
Five RCTs and three retrospective studies including a total of 445 cases were identified. We found that there was no significant difference in terms of LBOS, VAS, implant-related complications, kyphotic and VBH parameters. However, there was a significant difference regarding blood loss, operation time, segmental motion and donor site pain between fusion and non-fusion.
This meta-analysis demonstrated that posterior fixation alone could achieve satisfactory clinical and radiological results in treating thoracolumbar burst fracture. Moreover, posterior fixation without fusion was superior to additional fusion with less blood loss, shorter operation time, better segmental motion and lower donor site pain.
本荟萃分析旨在比较单纯后路固定（非融合）与融合辅助治疗胸腰椎爆裂骨折患者的疗效和安全性。
在PubMed、Embase和Cochrane图书馆全面检索相关文献。在荟萃分析中评估临床结局（腰椎功能障碍指数和视觉模拟评分）、手术结局（手术时间、失血量、住院时间和围手术期并发症）以及影像学结局（后凸角、椎体高度降低和节段活动度）。使用RevMan 5.3软件进行数据分析。
共纳入5项随机对照试验和3项回顾性研究，总计445例病例。我们发现，在腰椎功能障碍指数、视觉模拟评分、植入物相关并发症、后凸和椎体高度参数方面无显著差异。然而，融合组与非融合组在失血量、手术时间、节段活动度和供区疼痛方面存在显著差异。
本荟萃分析表明，单纯后路固定在治疗胸腰椎爆裂骨折时可取得满意的临床和影像学结果。此外，非融合后路固定优于附加融合，具有失血量更少、手术时间更短、节段活动度更好和供区疼痛更低的优势。
