Wang Yixi, Zhang Rui, Huang Qiuyuan, Xiao Yang, Kahaer Alafate, Rexiti Paerhati, Xia Ming
Department of Minimally Invasive Spine and Precision Orthopedics, Orthopedic Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Evidence-Based Medicine Research Center, School of Clinical Medicine, Tsinghua University, Beijing, China.
Neurosurg Rev. 2025 Mar 18;48(1):308. doi: 10.1007/s10143-025-03452-x.
This study combines pairwise and proportional meta-analyses to evaluate differences in outcomes and cost-efficiency between neurosurgeons (NS) and orthopedic surgeons (OS) for lumbar degenerative disease. Following PRISMA guidelines, PubMed, ScienceDirect, Ovid, Web of Science, and Springer Link were searched for studies comparing NS and OS outcomes. Results for pairwise meta-analysis were generated with the "metabin" function using standardized mean differences (SMD) for continuous variables and odds ratios (OR) for binary variables, while the "metaprop" function was used to calculate pooled proportions in proportional meta-analysis. The study was registered in PROSPERO (CRD42024545992). Of the 457 search results, 7 studies were included. Compared to OS patients, NS patients exhibited significantly higher overall complication rates [OR: 1.09 (95% CI: 1.03-1.15); NS: 9.49%, OS: 8.92%], hospital costs [SMD: 0.30 (95% CI: 0.28-0.31); NS: $37,251.78, OS: $31,024.18], and hospital stays [SMD: 0.03 (95% CI: 0.01-0.04); NS: 3.32 days, OS: 3.23 days], while with no significant differences in superficial surgical site infections [OR: 1.12 (95% CI: 0.97, 1.31); NS: 1.70%, OS: 1.13%], deep surgical site infections [OR: 1.09 (95% CI: 0.99, 1.20); NS: 0.78%, OS: 0.67%], wound dehiscence [OR: 1.10 (95% CI: 0.98, 1.22); NS: 0.66%, OS: 0.57%], pneumonia [OR: 1.06 (95% CI: 0.92, 1.22); NS: 1.29%, OS: 1.13%], urinary tract infections [OR: 1.22 (95% CI: 1.07, 1.38); NS: 1.51%, OS: 1.31%], sepsis [OR: 1.25 (95% CI: 0.97, 1.61); NS: 0.80%, OS: 0.58%], or pulmonary embolism [OR: 1.13 (95% CI: 0.85, 1.51); NS: 0.41%, OS: 0.35%]. NS patients showed lower, though insignificant, rates of deep vein thrombosis [OR: 0.95; NS: 0.66%, OS: 0.57%], unplanned readmissions [OR: 1.00; NS: 4.64%, OS: 4.67%], and reoperations [OR: 0.91; NS: 3.94%, OS: 4.25%] compared to OS patients. Despite differing training backgrounds, NS and OS show comparable outcomes overall, with unique strengths suggesting that collaborative efforts may enhance lumbar surgery outcomes.
本研究结合了成对和比例元分析，以评估神经外科医生（NS）和骨科医生（OS）在腰椎退行性疾病治疗中的疗效差异和成本效益。按照PRISMA指南，检索了PubMed、ScienceDirect、Ovid、Web of Science和Springer Link等数据库，查找比较NS和OS治疗效果的研究。使用“metabin”函数生成成对元分析结果，连续变量采用标准化均数差（SMD），二元变量采用比值比（OR）；比例元分析则使用“metaprop”函数计算合并比例。该研究已在PROSPERO注册（CRD42024545992）。在457条检索结果中，纳入了7项研究。与OS患者相比，NS患者的总体并发症发生率显著更高[OR：1.09（95%CI：1.03 - 1.15）；NS：9.49%，OS：8.92%]、住院费用[SMD：0.30（95%CI：0.28 - 0.31）；NS：3,7251.78美元，OS：31,024.18美元]和住院天数[SMD：0.03（95%CI：0.01 - 0.04）；NS：3.32天，OS：3.23天]，而在浅表手术部位感染[OR：1.12（95%CI：0.97，1.31）；NS：1.70%，OS：1.13%]、深部手术部位感染[OR：1.09（95%CI：0.99，1.20）；NS：0.78%，OS：0.67%]、伤口裂开[OR：1.10（95%CI：0.98，1.22）；NS：0.66%，OS：0.57%]、肺炎[OR：1.
Cochrane Database Syst Rev. 2016-11-1
Cochrane Database Syst Rev. 2014-2-14
Cochrane Database Syst Rev. 2015-2-20
Clin Neurol Neurosurg. 2023-11
Spine (Phila Pa 1976). 2023-5-1
Zotero 插件