Shandong Provincial Hospital, Shandong University, Shandong Province, China.
Pain Physician. 2019 Jul;22(4):323-330.
Percutaneous endoscopic debridement and drainage (PEDD) has played a vital role in the management of spinal infection; however, limited PEDD results are available to date.
The purpose of this systematic review is to examine the existing literature, to give an objective estimate of the outcomes of PEDD using a meta-analytical approach.
Meta-analysis and systematic review of retrospective single-arm studies.
A comprehensive online review was performed in MEDLINE, EMBASE, PubMed, Web of Science, and Cochrane databases from 1980 to October 2018. Eligible studies included the single-arm studies that mentioned PEDD in the management of spinal infection. Pooled event rates for positive bacteria culture, pain control satisfaction, and reoperation were estimated. The complications of PEDD were also recorded.
Nine single-arm PEDD articles (158 patients) were included. The pooled event rate was 82% (95% CI: 75%-88%) for positive bacteria culture, 81% (95% CI: 73%-87%) for pain control satisfaction, and 21% (95% CI: 15%-29%) for reoperation. There are few complications reported in the literature that included transient paresthesia in the affected lumbar segment and local kyphosis.
First, all included studies were retrospective series with inherent methodological limitations. Second, the sample size and the number of studies that were found to be eligible was small. In addition, all included studies are single-arm, and further studies are necessary in large randomized controlled trials on comparing the efficacy of conservative therapy, PEDD, and open surgical intervention.
PEDD not only has a high rate of causative-pathogen identification, but also provides satisfactory clinical outcome. Early PEDD intervention in spinal infection is encouraging; however, further studies in large randomized controlled trials on comparing the efficacy of conservative therapy, PEDD, and open surgical intervention are necessary.
Percutaneous endoscopic debridement and drainage, spinal infection, meta-analysis.
经皮内镜清创引流术（PEDD）在脊柱感染的治疗中发挥了重要作用；然而，迄今为止，PEDD 的结果有限。
本系统评价的目的是检查现有文献，通过荟萃分析方法对 PEDD 的结果进行客观评估。
回顾性单臂研究的荟萃分析和系统评价。
对 1980 年至 2018 年 10 月 MEDLINE、EMBASE、PubMed、Web of Science 和 Cochrane 数据库进行了全面的在线检索。纳入的研究包括在脊柱感染的治疗中提到 PEDD 的单臂研究。估计阳性细菌培养、疼痛控制满意度和再次手术的汇总事件率。还记录了 PEDD 的并发症。
纳入 9 篇 PEDD 单臂文章（158 例患者）。阳性细菌培养的汇总事件率为 82%（95%CI：75%-88%），疼痛控制满意度为 81%（95%CI：73%-87%），再次手术率为 21%（95%CI：15%-29%）。文献中报告的并发症很少，包括受累腰椎节段的短暂感觉异常和局部后凸。
首先，所有纳入的研究都是具有内在方法学局限性的回顾性系列研究。其次，样本量和符合条件的研究数量较少。此外，所有纳入的研究都是单臂研究，需要在大型随机对照试验中进一步比较保守治疗、PEDD 和开放手术干预的疗效。
PEDD 不仅具有较高的病原体鉴定率，而且提供了令人满意的临床结果。早期对脊柱感染进行 PEDD 干预是令人鼓舞的，但需要在大型随机对照试验中进一步比较保守治疗、PEDD 和开放手术干预的疗效。
经皮内镜清创引流术，脊柱感染，荟萃分析。
