微创与开放经椎间孔腰椎椎间融合术治疗多节段腰椎退行性疾病的比较:一项系统评价与Meta分析

Comparison between minimally invasive and open transforaminal lumbar interbody fusion for the treatment of multi‑segmental lumbar degenerative disease: A systematic evaluation and meta‑analysis.

作者信息

Zhai Wan-Jing, Wang Zhan-Kui, Liu Hua-Lv, Qin Shi-Lei, Han Peng-Fei, Xu Yun-Feng

机构信息

Graduate School, The First Clinical College of Changzhi Medical College, Changzhi, Shanxi 046000, P.R. China.

Department of Orthopedics, Changzhi Yunfeng Hospital, Changzhi, Shanxi 046000, P.R. China.

出版信息

Exp Ther Med. 2024 Feb 23;27(4):162. doi: 10.3892/etm.2024.12450. eCollection 2024 Apr.

Abstract

The present study aimed to compare the differences between minimally invasive transforaminal lumbar fusion (MIS-TLIF) and open transforaminal lumbar fusion (TLIF) for multi-segmental lumbar degenerative disease regarding intraoperative indices and postoperative outcomes. PubMed, Web of Science, Embase, CNKI, Wanfang and VIP databases were searched for literature on MIS-TLIF and open TLIF in treating multi-segmental lumbar degenerative diseases. Of the 1,608 articles retrieved, 10 were included for final analysis. The Newcastle-Ottawa Scale and Review Manager 5.4 were used for quality evaluation and data analysis, respectively. The MIS-TLIF group was superior to the open TLIF group regarding intraoperative blood loss [95% confidence interval (CI): -254.33,-157.86; P<0.00001], postoperative in-bed time (95%CI: -3.49,-2.76; P<0.00001), hospitalization time (95%CI: -5.14,-1.78; P<0.0001) and postoperative leg pain Visual Analog Scale score (95%CI: -0.27,-0.13; P<0.00001). The fluoroscopy frequency for MIS-TLIF (95%CI: 2.07,6.12; P<0.0001) was significantly higher than that for open TLIF. The two groups had no significant differences in operation time, postoperative drainage volume, postoperative complications, fusion rate, or Oswestry Disability Index score. In treating multi-segmental lumbar degenerative diseases, MIS-TLIF has the advantages of less blood loss, shorter bedtime and hospitalization time and improved early postoperative efficacy; however, open TLIF has a lower fluoroscopy frequency.

摘要

本研究旨在比较微创经椎间孔腰椎融合术(MIS-TLIF)与开放经椎间孔腰椎融合术(TLIF)治疗多节段腰椎退变性疾病时的术中指标及术后疗效差异。通过检索PubMed、Web of Science、Embase、中国知网、万方和维普数据库,查找关于MIS-TLIF和开放TLIF治疗多节段腰椎退变性疾病的文献。在检索到的1608篇文章中,最终纳入10篇进行分析。分别采用纽卡斯尔-渥太华量表和RevMan 5.4软件进行质量评估和数据分析。MIS-TLIF组在术中出血量[95%置信区间(CI):-254.33,-157.86;P<0.00001]、术后卧床时间(95%CI:-3.49,-2.76;P<0.00001)、住院时间(95%CI:-5.14,-1.78;P<0.0001)及术后腿痛视觉模拟量表评分(95%CI:-0.27,-0.13;P<0.00001)方面均优于开放TLIF组。MIS-TLIF的透视次数(95%CI:2.07,6.12;P<0.0001)显著高于开放TLIF组。两组在手术时间、术后引流量、术后并发症、融合率或Oswestry功能障碍指数评分方面无显著差异。在治疗多节段腰椎退变性疾病时,MIS-TLIF具有出血量少、卧床和住院时间短以及术后早期疗效改善的优势;然而,开放TLIF的透视次数较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ff2/10928985/e6fae4054798/etm-27-04-12450-g00.jpg

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