Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, India.
Eur Spine J. 2021 Jul;30(7):1835-1847. doi: 10.1007/s00586-021-06812-5. Epub 2021 Mar 19.
Hemivertebrectomy is widely used definitive correction surgery in congenital scoliosis due to hemivertebrae. It may be done either as combined anterior and posterior approach or a single-stage posterior approach only. The purpose of this meta-analysis was to compare two techniques with regards to blood loss, operative time, deformity correction and complications.
The systematic review and meta-analysis were conducted according to PRISMA guidelines among peer-reviewed journals published in English between June 2000 and June 2020. Quality appraisal of all selected articles was done and data extracted.
After thorough literature search and excluding, 37 studies were included for review. The commonest location of the hemivertebrae was thoracolumbar spine (51.3%), thoracic (26.2%), lumbar/lumbosacral (21.6%) followed by cervical (0.7%). Pooled data showed a significant difference (p < 0.05) in mean operative time with posterior only approach (227 min, 95% CI 205-250) as compared to Combined Anterior Posterior Approach (CAPA) (316 min 95% CI 291-341). Significant difference (p < 0.05) in mean blood loss was observed in posterior only approach (522 ml, 95% CI 434-611) as compared to CAPA (888 ml, 95% CI 663-1113). No significant difference was noted in mean correction in either of the approaches and overall pooled mean correction rate was 66%, 95% CI 61-72.
This review and meta-analysis of two surgical techniques of hemivertebrectomy, shows that operative time and blood loss is significantly lower in posterior only approach with no difference in correction rate as compared to CAPA. There was significant correlation between age at surgery and need for revision surgeries.
IV.
由于半椎体的存在，半椎体切除术被广泛应用于先天性脊柱侧凸的确定性矫形手术。它可以通过前路和后路联合入路或一期后路入路完成。本荟萃分析的目的是比较两种技术在出血量、手术时间、畸形矫正和并发症方面的差异。
根据 PRISMA 指南，对 2000 年 6 月至 2020 年 6 月期间发表的同行评审英文期刊进行了系统评价和荟萃分析。对所有入选文章进行质量评估并提取数据。
经过彻底的文献检索和排除，有 37 项研究被纳入综述。半椎体最常见的部位是胸腰椎（51.3%）、胸椎（26.2%）、腰椎/腰骶（21.6%），其次是颈椎（0.7%）。汇总数据显示，后路仅手术组的平均手术时间（227 分钟，95%CI 205-250）与前路和后路联合手术组（316 分钟，95%CI 291-341）相比有显著差异（p<0.05）。后路仅手术组的平均出血量（522 毫升，95%CI 434-611）与前路和后路联合手术组（888 毫升，95%CI 663-1113）相比有显著差异（p<0.05）。两种手术方法的平均矫正值无显著差异，总体平均矫正率为 66%，95%CI 61-72。
本荟萃分析比较了半椎体切除术的两种手术技术，结果表明后路仅手术组的手术时间和出血量明显低于前路和后路联合手术组，但矫正率无差异。手术时的年龄与需要再次手术之间存在显著相关性。
IV 级。
