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微创脊柱侧弯手术是治疗特发性脊柱侧弯的一种可行选择,且与开放手术疗效相当:一项荟萃分析

Minimally Invasive Scoliosis Surgery Is a Feasible Option for Management of Idiopathic Scoliosis and Has Equivalent Outcomes to Open Surgery: A Meta-Analysis.

作者信息

Alhammoud Abduljabbar, Alborno Yahya, Baco Abdul Moeen, Othman Yahya Azhar, Ogura Yoji, Steinhaus Michael, Sheha Evan D, Qureshi Sheeraz A

机构信息

Hamad Medical Corporation, Doha, Qatar.

Kaiser Permanente Oakland Medical Center, Oakland, CA, USA.

出版信息

Global Spine J. 2022 Apr;12(3):483-492. doi: 10.1177/2192568220988267. Epub 2021 Feb 9.

Abstract

STUDY DESIGN

Meta-analysis.

OBJECTIVE

To compare outcomes between minimally invasive scoliosis surgery (MISS) and traditional posterior instrumentation and fusion in the correction of adolescent idiopathic scoliosis (AIS).

METHODS

A literature search was performed using MEDLINE, PubMed, EMBASE, Google scholar and Cochrane databases, including studies reporting outcomes for both MISS and open correction of AIS. Study details, demographics, and outcomes, including curve correction, estimated blood loss (EBL), operative time, postoperative pain, length of stay (LOS), and complications, were collected and analyzed.

RESULTS

A total of 4 studies met the selection criteria and were included in the analysis, totaling 107 patients (42 MIS and 65 open) with a mean age of 16 years. Overall there was no difference in curve correction between MISS (73.2%) and open (76.7%) cohorts. EBL was significantly lower in the MISS (271 ml) compared to the open (527 ml) group, but operative time was significantly longer (380 min for MISS versus 302 min for open). There were no significant differences between the approaches in pain, LOS, complications, or reoperations.

CONCLUSION

MISS was associated with less blood loss but longer operative times compared to traditional open fusion for AIS. There was no difference in curve correction, postoperative pain, LOS, or complications/reoperations. While MISS has emerged as a feasible option for the surgical management of AIS, further research is warranted to compare these 2 approaches.

摘要

研究设计

荟萃分析。

目的

比较微创脊柱侧弯手术(MISS)与传统后路内固定融合术在矫正青少年特发性脊柱侧弯(AIS)方面的疗效。

方法

使用MEDLINE、PubMed、EMBASE、谷歌学术和Cochrane数据库进行文献检索,纳入报告了MISS和AIS开放矫正术疗效的研究。收集并分析研究细节、人口统计学数据及疗效,包括侧弯矫正、估计失血量(EBL)、手术时间、术后疼痛、住院时间(LOS)和并发症。

结果

共有4项研究符合入选标准并纳入分析,共计107例患者(42例MISS和65例开放手术),平均年龄16岁。总体而言,MISS组(73.2%)和开放手术组(76.7%)在侧弯矫正方面无差异。与开放手术组(527毫升)相比,MISS组的EBL显著更低(271毫升),但手术时间显著更长(MISS组为380分钟,开放手术组为302分钟)。两种手术方式在疼痛、LOS、并发症或再次手术方面无显著差异。

结论

与AIS的传统开放融合术相比,MISS的失血量更少,但手术时间更长。在侧弯矫正、术后疼痛、LOS或并发症/再次手术方面无差异。虽然MISS已成为AIS手术治疗的一种可行选择,但仍需进一步研究以比较这两种手术方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be5c/9121169/38e6eda0b9e6/10.1177_2192568220988267-fig1.jpg

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