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不同斜外侧腰椎椎间融合术治疗腰椎退行性疾病的影像学和临床结果差异:一项系统评价和贝叶斯网络Meta分析

Differences in radiographic and clinical outcomes of different oblique lumbar interbody fusions for lumbar degenerative diseases: a systematic review and Bayesian network meta-analysis.

作者信息

Dai Zhiyuan, Yang Haomiao, Yan Yinjia, Zhu Shuhe, Qian Weiqing

机构信息

Nanjing TCM Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, 157 Daming Road, Nanjing, Qinhuai District, 210022, China.

出版信息

Neurosurg Rev. 2025 Jan 30;48(1):121. doi: 10.1007/s10143-025-03297-4.

Abstract

To systematically evaluate the differences in the clinical efficacy of lumbar degenerative disorders (LDDs) treatment between oblique lumbar interbody fusion with percutaneous pedicle screw fixation (OLIF-PF), OLIF stand-alone (OLIF-SA), and OLIF with anterolateral screw fixation (OLIF-AF). A systematic search was conducted on both English and Chinese databases, wherein the literature was screened based on title, abstract, and full text. Literature that met the inclusion criteria was assessed for quality and relevant information was extracted. The main outcome indicators were recorded and Bayesian network meta-analyses were performed. A thorough evaluation was conducted on the 12 papers that satisfied the inclusion criteria. Among these articles, 5 studies compared OLIF-PF with OLIF-SA, 5 studies compared OLIF-PF with OLIF-AF, and 2 studies compared OLIF-PF, OLIF-SA, and OLIF-AF. According to the included articles, a total of 758 people were treated with OLIF surgery (341 individuals covered in OLIF-PF group, 288 individuals covered in OLIF-SA group, and 129 individuals covered in OLIF-129 group). Pooled analysis showed that OLIF-PF performed better in terms of imaging outcomes compared to OLIF-SA and OLIF-AF. However, in terms of surgical duration and intraoperative blood loss, OLIF-PF showed a significant disadvantage compared to the other two surgical procedures. The ODI scores exhibited a preference for OLIF-AF, indicating a marginal superiority of OLIF-AF with regard to clinical outcomes. It is advisable for physicians to carefully select the most suitable OLIF procedure, taking into account their expertise and the individual requirements of each patient.

摘要

为系统评估斜外侧腰椎椎间融合术联合经皮椎弓根螺钉内固定术(OLIF-PF)、单纯斜外侧腰椎椎间融合术(OLIF-SA)和斜外侧腰椎椎间融合术联合前外侧螺钉内固定术(OLIF-AF)治疗腰椎退变性疾病(LDDs)的临床疗效差异。对英文和中文数据库进行了系统检索,根据标题、摘要和全文筛选文献。对符合纳入标准的文献进行质量评估并提取相关信息。记录主要结局指标并进行贝叶斯网络荟萃分析。对符合纳入标准的12篇论文进行了全面评估。在这些文章中,5项研究比较了OLIF-PF与OLIF-SA,5项研究比较了OLIF-PF与OLIF-AF,2项研究比较了OLIF-PF、OLIF-SA和OLIF-AF。根据纳入的文章,共有758人接受了OLIF手术(OLIF-PF组341例,OLIF-SA组288例,OLIF-129组129例)。汇总分析表明,与OLIF-SA和OLIF-AF相比,OLIF-PF在影像学结果方面表现更好。然而,在手术时间和术中出血量方面,OLIF-PF与其他两种手术方法相比存在显著劣势。ODI评分显示对OLIF-AF有偏好,表明OLIF-AF在临床结局方面略有优势。建议医生根据自己的专业知识和每个患者的个体需求,仔细选择最合适的OLIF手术方法。

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