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磁控生长棒治疗早发性脊柱侧凸的系统评价和荟萃分析。

Magnetically Controlled Growing Rod for Early-Onset Scoliosis: Systematic Review and Meta-Analysis.

机构信息

Department of Orthopedics, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China.

Department of Orthopedics, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China.

出版信息

World Neurosurg. 2019 May;125:e593-e601. doi: 10.1016/j.wneu.2019.01.136. Epub 2019 Feb 1.

Abstract

BACKGROUND

The goal of the current systematic review and meta-analysis was to explore the utilization of a magnetically controlled growing rod (MCGR) for the treatment of early-onset scoliosis based on eligible studies demonstrating efficacy.

METHODS

Online electronic databases were searched to identify the eligible studies updated to April 2018 according to index words. Several studies in the literature that were relevant to the present analysis were also included. Mean difference or relative risk along with 95% confidence interval was used to analyze the main outcomes.

RESULTS

Eleven studies were included in the meta-analysis with 186 patients in the MCGR group and 64 patients in the conventionally growing rod (CGR) group; 3 studies were case control studies, and 8 studies were self-control studies. The results indicated that MCGR had significantly decreased the Cobb angle and thoracic kyphosis and increased T1-T12 and T1-S1 distances. In addition, the incidence of complications after MCGR therapy was 0.37%. However, there was no significant difference in the change of Cobb angle and incidence of complications between the MCGR and CGR groups.

CONCLUSIONS

We demonstrated that MCGR significantly reduced the Cobb angle and thoracic kyphosis while markedly increasing T1-T12 and T1-S1 distances. However, a close comparison of MCGR with CGR reveals more high-quality randomized control trials with a larger sample size and long-term follow-ups are necessary to gather more robust evidence on the efficacy of MCGR for early-onset scoliosis.

摘要

背景

本系统评价和荟萃分析的目的是基于证明疗效的合格研究,探讨使用磁控生长棒(MCGR)治疗早发性脊柱侧凸。

方法

根据索引词,在线电子数据库中搜索到 2018 年 4 月更新的合格研究。还包括了一些与本分析相关的文献中的研究。使用均值差或相对风险及其 95%置信区间分析主要结果。

结果

荟萃分析纳入 11 项研究,MCGR 组 186 例,传统生长棒(CGR)组 64 例;3 项为病例对照研究,8 项为自身对照研究。结果表明,MCGR 显著降低了 Cobb 角和胸椎后凸,增加了 T1-T12 和 T1-S1 的距离。此外,MCGR 治疗后的并发症发生率为 0.37%。然而,MCGR 和 CGR 两组的 Cobb 角变化和并发症发生率无显著差异。

结论

我们表明,MCGR 显著降低了 Cobb 角和胸椎后凸,同时显著增加了 T1-T12 和 T1-S1 的距离。然而,MCGR 与 CGR 的密切比较需要更多高质量的随机对照试验,具有更大的样本量和长期随访,以收集关于 MCGR 治疗早发性脊柱侧凸疗效的更有力证据。

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