Neurosurgery Department, The Second People's Hospital of Guiyang, Guiyang, China.
Neurosurgery Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
Ann Palliat Med. 2021 Dec;10(12):12678-12689. doi: 10.21037/apm-21-3533.
Thoracolumbar fractures have the characteristics of acute onset, rapid change, and severe trauma. The best way to treat thoracolumbar fractures is through fracture reduction surgery. The surgical methods include percutaneous pedicle screw, posterior percutaneous pedicle screw internal fixation, and open pedicle screw internal fixation.
We searched the PubMed, Embase, and Medline English database from April 1991 to April 2021, and the keywords included "percutaneous tablet screen", "posterior percutaneous tablet screen fixation", "open tablet screen fixation", "fracture of thoracic vertebrae", "thoracic fractures", "thoracic", and "vascular fracture". RevMan5.3 provided by Cochrane was used for meta-analysis.
A total of 9 articles were included in this study. Percutaneous pedicle screw fixation and posterior percutaneous pedicle screw fixation were adopted as the surgical methods, and patients were enrolled into experimental and control groups. Open pedicle screw internal fixation was set as the control group. The mean difference (MD) of operation time, blood loss, pain score, postoperative complications, screw debris rate, and hospital stay were -0.73, -192.16, -0.70, 1.49, 0.32, and -1.26, respectively; 95% confidence intervals (CIs) were (-0.94, -0.51), (-213.23, -171.09), (-0.82, -0.57), (0.47, 4.79), (0.10, 0.99), and (-1.82, -0.71), respectively; Z values were 6.71, 17.87, 10.95, 0.67, 1.97, and 4.46, respectively; and P values were <0.00001, <0.00001, <0.00001, 0.50, 0.05, and <0.00001, respectively.
A total of 9 articles were included in this meta-analysis. Compared with open surgery, the use of percutaneous pedicle screw and posterior percutaneous pedicle screw fixation had less blood loss, shorter operation time, shorter hospital stay, less pain, as well as lower screw dislocation and postoperative infection rates, indicating that the use of percutaneous pedicle screw and posterior percutaneous pedicle screw fixation is more effective than open surgery.
胸腰椎骨折具有发病急、变化快、创伤重的特点。治疗胸腰椎骨折的最佳方法是骨折复位手术。手术方法包括经皮椎弓根螺钉、后路经皮椎弓根螺钉内固定和开放椎弓根螺钉内固定。
我们检索了 1991 年 4 月至 2021 年 4 月的 PubMed、Embase 和 Medline 英文数据库，关键词包括“经皮片屏”、“后路经皮片屏固定”、“开放片屏固定”、“胸椎体骨折”、“胸骨折”、“胸”和“血管骨折”。Cochrane 提供的 RevMan5.3 用于荟萃分析。
本研究共纳入 9 篇文章。采用经皮椎弓根螺钉固定和后路经皮椎弓根螺钉固定作为手术方法，将患者纳入实验组和对照组。开放性椎弓根螺钉内固定作为对照组。手术时间、出血量、疼痛评分、术后并发症、螺钉残片率和住院时间的均数差值（MD）分别为-0.73、-192.16、-0.70、1.49、0.32 和-1.26；95%置信区间（CI）分别为（-0.94，-0.51）、（-213.23，-171.09）、（-0.82，-0.57）、（0.47，4.79）、（0.10，0.99）和（-1.82，-0.71）；Z 值分别为 6.71、17.87、10.95、0.67、1.97 和 4.46；P 值均<0.00001。
本荟萃分析共纳入 9 篇文章。与开放性手术相比，经皮椎弓根螺钉和后路经皮椎弓根螺钉固定术出血量少、手术时间短、住院时间短、疼痛轻、螺钉脱位和术后感染率低，表明经皮椎弓根螺钉和后路经皮椎弓根螺钉固定术比开放性手术更有效。
