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[1]陳雙,吳奐汐,王楠,等.腰椎后路融合術(shù)后融合器沉降危險(xiǎn)因素的Meta分析[J].中醫(yī)正骨,2022,34(10):44-52.
　CHEN Shuang,WU Huanxi,WANG Nan,et al.A Meta-analysis of risk factors associated with cage subsidence after posterior lumbar interbody fusion[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(10):44-52.
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腰椎后路融合術(shù)后融合器沉降危險(xiǎn)因素的Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年10期
頁(yè)碼:
44-52
欄目:
文獻(xiàn)研究
出版日期:
2022-10-20

文章信息/Info

Title:
A Meta-analysis of risk factors associated with cage subsidence after posterior lumbar interbody fusion
作者:
陳雙1; 吳奐汐2; 王楠1; 謝林3
(1.南京中醫(yī)藥大學(xué)第三臨床醫(yī)學(xué)院,江蘇 南京 210029; 2.南京中醫(yī)藥大學(xué)第二臨床醫(yī)學(xué)院,江蘇 南京 210029; 3.南京中醫(yī)藥大學(xué)附屬中西醫(yī)結(jié)合醫(yī)院,江蘇 南京 210028)
Author(s):
CHEN Shuang1; WU Huanxi2; WANG Nan1; XIE Lin3
1.The Third Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China 2.The Second Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China 3.Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing 210028,Jiangsu,China
關(guān)鍵詞:
脊柱融合術(shù);  腰椎;  融合器沉降;  危險(xiǎn)因素;  專題Meta分析
Keywords:
spinal fusion;  lumbar vertebrae;  cage subsidence;  risk factors;  meta-analysis as topic
摘要:
目的:探討腰椎后路融合術(shù)后融合器沉降的危險(xiǎn)因素。方法:應(yīng)用計(jì)算機(jī)檢索中國(guó)知網(wǎng)、萬(wàn)方數(shù)據(jù)庫(kù)、維普網(wǎng)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)、PubMed、Embase、Cochrane Library中有關(guān)腰椎后路融合術(shù)后融合器沉降危險(xiǎn)因素分析的文獻(xiàn),檢索時(shí)限均為建庫(kù)至2022年3月。按照納入和排除標(biāo)準(zhǔn)篩選文獻(xiàn),采用紐卡斯?fàn)?渥太華量表進(jìn)行文獻(xiàn)質(zhì)量評(píng)價(jià),提取數(shù)據(jù)后使用RevMan5.3軟件進(jìn)行Meta分析。結(jié)果:共檢索到822篇文獻(xiàn),最終納入10篇文獻(xiàn)。Meta分析結(jié)果顯示,年齡、骨質(zhì)疏松、椎間隙高度矯正值、節(jié)段性前凸角矯正值、融合器位于椎間隙后部均為腰椎后路融合術(shù)后融合器沉降的危險(xiǎn)因素[MD=2.97,95%CI(1.86,4.08),P=0.000; OR=5.15,95%CI(3.08,8.60),P=0.000; MD=-0.42,95%CI(-0.77,-0.06),P=0.020; MD=1.84,95%CI(1.39,2.29),P=0.000; OR=1.93,95%CI(1.09,3.42),P=0.020]; 女性、體質(zhì)量指數(shù)、合并腰椎滑脫癥、融合器長(zhǎng)度≥24 mm、融合器高度≥12 mm、手術(shù)節(jié)段為L(zhǎng)5S1、融合節(jié)段≥2節(jié)段,與腰椎后路融合術(shù)后融合器沉降的關(guān)聯(lián)無(wú)統(tǒng)計(jì)學(xué)意義[OR=1.07,95%CI(0.80,1.42),P=0.670; MD=0.13,95%CI(-0.30,0.55),P=0.560; OR=1.20,95%CI(0.84,1.73),P=0.320; OR=0.75,95%CI(0.38,1.48),P=0.410; OR=1.08,95%CI(0.60,1.95),P=0.790; OR=1.25,95%CI(0.90,1.74),P=0.180; OR=1.80,95%CI(0.93,3.51),P=0.080]。描述性分析結(jié)果顯示,術(shù)中損傷終板是腰椎后路融合術(shù)后融合器沉降的危險(xiǎn)因素。基于年齡的發(fā)表偏倚分析結(jié)果提示,存在發(fā)表偏倚的可能性較小。結(jié)論:年齡、骨質(zhì)疏松、椎間隙高度矯正值、節(jié)段性前凸角矯正值、融合器位于椎間隙后部、術(shù)中損傷終板是腰椎后路融合術(shù)后融合器沉降的危險(xiǎn)因素。
Abstract:
Objective:To investigate the risk factors associated with cage subsidence after posterior lumbar interbody fusion(PLIF).Methods:The research articles about risk factors associated with cage subsidence after PLIF were retrieved from CNKI,Wanfang Data,VIP,SinoMed,PubMed,Embase,and Cochrane Library from database inception to March 2022,and screened out according to inclusion and exclusion criteria.The Newcastle-Ottawa Scale was used to evaluate the literature quality,and RevMan 5.3 software was used for Meta-analysis after data extraction.Results:A total of 822 research articles were obtained,and 10 were finally included.As revealed by Meta-analysis,age,osteoporosis,correction value of intervertebral space height,correction value of segmental lordosis,and cage in the posterior intervertebral space were risk factors leading to cage subsidence after PLIF(MD=2.97,95%CI(1.86,4.08),P=0.000; OR=5.15,95% CI(3.08,8.60),P=0.000; MD=-0.42,95%CI(-0.77,-0.06),P=0.020; MD=1.84,95%CI(1.39,2.29),P=0.000; OR=1.93,95%CI(1.09,3.42),P=0.020).Female,body mass index,combined lumbar spondylolisthesis,cage length of≥24 mm,cage height of≥12 mm,L5S1 fusion surgery,and number of fusion segments of≥2 were not significantly associated with cage subsidence after PLIF(OR=1.07,95%CI(0.80,1.42),P=0.670; MD=0.13,95%CI(-0.30,0.55),P=0.560; OR=1.20,95%CI(0.84,1.73),P=0.320; OR=0.75,95%CI(0.38,1.48),P=0.410; OR=1.08,95%CI(0.60,1.95),P=0.790; OR=1.25,95%CI(0.90,1.74),P=0.180; OR=1.80,95%CI(0.93,3.51),P=0.080).The results of descriptive analysis indicated that intraoperative endplate injury also served as a risk factor for cage subsidence after PLIF.The analysis of publication bias based on age suggested that there was less potential for publication bias.Conclusion:Age,osteoporosis,correction value of intervertebral space height,correction value of segmental lordosis,cage in the posterior intervertebral space,and intraoperative endplate injury were all risk factors resulting in cage subsidence after PLIF.

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備注/Memo

備注/Memo:
基金項(xiàng)目:江蘇省中醫(yī)藥科技發(fā)展計(jì)劃項(xiàng)目(ZD202008) 通訊作者:謝林 E-mail:[email protected]
更新日期/Last Update: 1900-01-01