Lin Ying, Chen Qiaoling, Wang RouMei, Zhang Bing, Huang Rui, Bai Yiguang
Department of Orthopedics, Beijing Anzhen Nanchong Hospital, Capital Medical University (Nanchong Central Hospital), Nanchong, China.
Department of Orthopedics, Nanchong Central Hospital, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China.
Front Med (Lausanne). 2025 Jul 17;12:1536391. doi: 10.3389/fmed.2025.1536391. eCollection 2025.
Lumbar disk herniation is a prevalent spinal disorder. Continuity of care ensures seamless, coordinated, and high-quality management across healthcare transitions to optimize outcomes and reduce readmission risk. Insufficient structured postoperative care programs after diskharge may hinder recovery, lower quality of life, and increase complication risks.
This study aims to explore the significance of continuity of care in enhancing the recovery outcomes of patients with lumbar disk herniation post-surgery through a meta-analysis.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted an extensive search across several databases, including MEDLINE (PubMed), EMBASE, Web of Science, Google Scholar, CINAHL, EBSCO, Cochrane Library and Scopus, without restrictions on language or publication date. A meta-analysis was performed using both fixed-effects and random-effects models based on heterogeneity assessment. We analyzed the data using R software version 4.2.2 and Stata software version 15.1. The risk of bias was assessed using the Cochrane Risk of Bias Tool, the Newcastle-Ottawa Scale (NOS), funnel plots, sensitivity analysis, Egger's test, and Begg's test.
This study included a total of 15 studies, involving 1,804 participants. The meta-analysis results showed that the experimental group had significantly lower Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Self-Rating Anxiety Scale (SAS) scores 3 months post-operation compared to the conventional control group [SMD = -0.66, 95% CI (-0.91, -0.41), SMD = -0.91, 95%CI (-1.24, -0.58), SMD = -0.61, 95% CI (-0.91, -0.31), < 0.01]. Additionally, the Japanese Orthopedic Association (JOA) score of the experimental group was significantly higher than that of the conventional control group at 3 months post-operation [SMD = 1.70, 95%CI (1.01, 2.39), < 0.01].
Our meta-analysis indicates that continued care interventions significantly alleviate postoperative pain, enhance lumbar function, reduce anxiety, and improve overall functional recovery in LDH patients. High-quality continued care interventions are critical strategies for enhancing postoperative recovery outcomes. Nonetheless, as the included primary studies predominantly originate from China, further validation of these findings in diverse regions and populations is warranted in future research.
PROSPERO https://www.crd.york.ac.uk/prospero/, identifier CRD42024604420.
腰椎间盘突出症是一种常见的脊柱疾病。连续性护理可确保在医疗保健过渡过程中实现无缝、协调和高质量的管理,以优化治疗效果并降低再入院风险。出院后缺乏结构化的术后护理计划可能会阻碍康复、降低生活质量并增加并发症风险。
本研究旨在通过荟萃分析探讨连续性护理对提高腰椎间盘突出症患者术后康复效果的意义。
按照系统评价和荟萃分析的首选报告项目(PRISMA)指南,我们在多个数据库中进行了广泛检索,包括MEDLINE(PubMed)、EMBASE、科学网(Web of Science)、谷歌学术、CINAHL、EBSCO、考克兰图书馆和Scopus,对语言和出版日期均无限制。根据异质性评估,使用固定效应模型和随机效应模型进行荟萃分析。我们使用R软件4.2.2版和Stata软件15.1版分析数据。使用考克兰偏倚风险工具、纽卡斯尔-渥太华量表(NOS)、漏斗图、敏感性分析、埃格检验和贝格检验评估偏倚风险。
本研究共纳入15项研究,涉及1804名参与者。荟萃分析结果显示,与传统对照组相比,实验组术后3个月的视觉模拟量表(VAS)、Oswestry功能障碍指数(ODI)和自评焦虑量表(SAS)得分显著更低[标准化均数差(SMD)=-0.66,95%置信区间(CI)(-0.91,-0.41),SMD=-0.91,95%CI(-1.24,-0.58),SMD=-0.61,95%CI(-0.91,-0.31),P<0.01]。此外,实验组术后3个月的日本骨科协会(JOA)评分显著高于传统对照组[SMD=1.70,95%CI(1.01,2.39),P<0.01]。
我们的荟萃分析表明,持续护理干预可显著减轻术后疼痛、增强腰椎功能、减轻焦虑并改善腰椎间盘突出症患者的整体功能恢复。高质量的持续护理干预是提高术后康复效果的关键策略。尽管如此,由于纳入的原始研究主要来自中国,则在未来研究中对不同地区和人群进一步验证这些结果是有必要的。
PROSPERO(https://www.crd.york.ac.uk/prospero/),标识符CRD42024604420。