后路椎体截骨术对接受成人脊柱畸形手术治疗患者的健康相关生活质量（HRQOL）评估的影响：系统评价和荟萃分析。
Impact of pedicle subtraction osteotomy on health-related quality of life (HRQOL) measures in patients undergoing surgery for adult spinal deformity: a systematic review and meta-analysis.
机构信息
Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
出版信息
Eur Spine J. 2020 Dec;29(12):2953-2959. doi: 10.1007/s00586-020-06439-y. Epub 2020 May 7.
STUDY DESIGN
Systematic review and meta-analysis.
BACKGROUND
Three-column osteotomies (3-CO) have gained popularity in the last decade as part of the armamentarium for the surgical correction of sagittal imbalance in patients with adult spinal deformity (ASD). Three-column osteotomies in the form of pedicle subtraction osteotomy (PSO) may be necessary to achieve adequate correction for severe and rigid spinal deformity. Studies reporting improvement in health-related quality of life (HRQOL) with validated outcome measures after PSO surgery are sparse and currently consist of small series.
OBJECTIVE
Evaluate the improvement in HRQOL measures following PSO for adult spinal deformity.
METHODS
Two independent reviewers conducted a systematic review of the English literature between period 1996 and 2019 for articles reporting outcome of PSO in patients with ASD according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Inclusion criteria were studies consisting of patient-reported outcome Oswestry Disability Index (ODI) and Scoliosis Research Society 22 or 24 (SRS) outcomes after PSO surgery for adult spine deformity patients (18 years or older) with a minimum follow-up of 1 year.
RESULTS
Eight studies with 431 PSOs were included in the meta-analysis. The results showed a statistically significant improvement in ODI in PSO (P < 0.0001), and the mean clinically important difference was achieved with both ODI (50.46 (45.5-55.4) preoperatively to 32.78 (29.7-39) postoperatively) and SRS (2.49 (2.38-2.7) preoperatively to 3.26 (2.8-4.1) postoperatively) scores.
CONCLUSION
This meta-analysis did find improvements in the health-related quality of life in patients undergoing PSO surgery for adult spinal deformity.
研究设计
系统评价和荟萃分析。
背景
三柱截骨术（3-CO）作为治疗成人脊柱畸形（ASD）矢状面失平衡的方法之一，在过去十年中得到了广泛应用。对于严重和僵硬的脊柱畸形，可能需要进行三柱截骨术（PSO）中的经椎弓根截骨术（PSO）来实现充分矫正。目前，仅有少量小系列研究报告了经 PSO 手术后健康相关生活质量（HRQOL）的改善，并使用经过验证的结局测量方法。
目的
评估经 PSO 治疗成人脊柱畸形后 HRQOL 指标的改善情况。
方法
两位独立的审查员根据 PRISMA（系统评价和荟萃分析的首选报告项目）指南，对 1996 年至 2019 年间发表的报告 ASD 患者 PSO 结果的英文文献进行了系统评价。纳入标准为：研究包括 PSO 术后患者报告的 Oswestry 功能障碍指数（ODI）和脊柱侧凸研究协会 22 或 24 项（SRS）结果，患者为成人脊柱畸形（18 岁或以上），且随访时间至少为 1 年。
结果
共有 8 项研究，包含 431 例 PSO 纳入荟萃分析。结果显示，PSO 术后 ODI 显著改善（P<0.0001），ODI（术前 50.46（45.5-55.4）至术后 32.78（29.7-39），临床意义差值为 50.46-17.69）和 SRS（术前 2.49（2.38-2.7）至术后 3.26（2.8-4.1），临床意义差值为 0.77）评分均达到了临床意义差值。
结论
本荟萃分析确实发现了经 PSO 治疗成人脊柱畸形后患者生活质量的改善。
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