Hosseini Seyedmorteza, Niakan Amin, Dehghankhalili Maryam, Dehdab Reza, Shahjouei Shima, Rekabdar Yasamin, Shaghaghian Elaheh, Shaghaghian Alireza, Ghaffarpasand Fariborz
Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran.
Trauma Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Heliyon. 2021 Jun 11;7(6):e07286. doi: 10.1016/j.heliyon.2021.e07286. eCollection 2021 Jun.
Failed Back Surgery Syndrome (FBSS) is persistent pain and disability following lumbar laminectomy which is associated with decreased quality of life and disability and has been reported in up to 40% of the patients undergoing lumbar laminectomy. Several approaches have been introduced to reduce the rate of the FBSS. Among these, applying anti-adhesive barrier gels have been studied with interest with controversial results. The aim of the current study was to determine the effects of anti-adhesive barrier gels on functional outcome and recurrence of patients undergoing lumbar disc surgery. We searched databases including EMBASE, PUBMED, Web of Science, Scopus, Cochrane Library, and scholar databases until November 2019. To assess the heterogeneity across included studies was used Cochran's Q and I-square (I) statistics. Standardized mean difference (SMD) and 95% CI between were used to estimate pooled effect sizes. Out of 4507, 10 clinical trials found to be appropriate for current meta-analysis. The pooled results of included clinical trials indicated that adhesion barrier gel significantly decreased leg pain (LP) (SMD = -0.31; 95% CI, -0.60, -0.03; P = 0.032; I: 59.2%) among patients with lumbar disc herniation surgery. Back pain (BP) (SMD = -0.03; 95% CI, -0.23, 0.16; P = 0.734; I: 40.2%), and Oswestry disability index (ODI) (SMD = -0.11; 95% CI, -0.27, 0.05; P = 0.178; I: 0.0%), were not significantly affected following adhesion barrier gel application. Application of adhesion barrier gel in single level lumbar disc surgery is associated with deceased leg pain. However, its application does not affect the low back pain, disability and gate. Further, larger randomized clinical trials are required.
腰椎手术失败综合征（FBSS）是腰椎椎板切除术后持续存在的疼痛和功能障碍，与生活质量下降和功能障碍相关，据报道，在接受腰椎椎板切除术的患者中，高达40%的人会出现这种情况。已经引入了几种方法来降低FBSS的发生率。其中，应用抗粘连屏障凝胶受到了关注，但结果存在争议。本研究的目的是确定抗粘连屏障凝胶对接受腰椎间盘手术患者的功能结局和复发的影响。我们检索了包括EMBASE、PUBMED、Web of Science、Scopus、Cochrane图书馆和学术数据库在内的数据库，直至2019年11月。为了评估纳入研究之间的异质性，使用了Cochran's Q和I²（I）统计量。使用标准化均值差（SMD）和95%置信区间（CI）来估计合并效应大小。在4507项研究中，发现10项临床试验适合当前的荟萃分析。纳入临床试验的汇总结果表明，在腰椎间盘突出症手术患者中，粘连屏障凝胶显著减轻了腿痛（LP）（SMD = -0.31；95% CI，-0.60，-0.03；P = 0.032；I：59.2%）。应用粘连屏障凝胶后，背痛（BP）（SMD = -0.03；95% CI，-0.23，0.16；P = 0.734；I：40.2%）和奥斯威斯利功能障碍指数（ODI）（SMD = -0.11；CL，-0.27，0.05；P = 0.178；I：0.0%）没有受到显著影响。在单节段腰椎间盘手术中应用粘连屏障凝胶与腿痛减轻有关。然而，其应用并不影响腰痛、功能障碍和步态。此外，还需要更大规模的随机临床试验。
