摘要
目的：利用Meta分析的方法在较大样本量的前提下,比较国内应用颈椎前路减压加植骨融合与加用颈椎前路带锁钛板置入内固定治疗脊髓型颈椎病的有效性和安全性。资料来源：计算机检索中国生物医学文献数据库（CBM,1998-01/2008-12）、中国期刊全文数据库（CNKI,1994-01/2008-12）、维普中文科技期刊数据库（VIP,1989-01/2008-12）,及所有相关文章的参考文献。资料选择：临床随机对照试验。观察颈椎前路减压加植骨融合与加用颈椎前路带锁钛板内固定治疗治疗脊髓型颈椎病的有效性和安全性,除外无对照组,或应用椎体成形术者。结局评价指标：JOA评分、并发症及骨融合率。结果：有6个临床对照研究符合纳入标准,共纳入443例患者。其中行单纯颈椎前路减压加植骨融合的对照组患者190例,加用颈椎前路带锁钛板内固定的试验组患者253例。并对6个临床对照研究进行了Meta分析。①加用前路带锁钛板内固定治疗组在疗效上优于单纯减压植骨融合组（比值比OR=2.30和95%可信区间为1.32-4.01,P〈0.05）。②加用前路带锁钛板内固定治疗组融合率高于单纯减压植骨融合组（比值比OR=3.61和95%可信区间为1.44-9.08,P〈0.05）。③加用前路带锁钛板内固定治疗组并发症少于单纯减压植骨融合组（比值比OR=0.08和95%可信区间为0.02-0.30,P〈0.05）。结论：纳入6篇文献的meta分析结果显示颈椎前路减压加植骨融合前路带锁钛板内固定治疗脊髓型颈椎病是安全的,颈椎前路减压加植骨融合前路带锁钛板内固定比颈椎前路减压加植骨融合具有更好的临床效果。但因纳入的样本量偏小,且对并发症报道量不大。因此仍有可能存在一些不确定的问题,需要设计良好、方法学质量更高的随机对照试验来解决。
OBJECTIVE： To compare safety and efficacy between anterior cervical decompression and fusion procedures as well as compound titanium rete implantation for the treatment of cervical spondylotic myelopathy using Meta analysis. DATA SOURCE： The relative articles were retrieved from Chinese Biomedical Literature Database （CBM） from January 1998 to December 2008, CNKI from January 1994 to December 2008, and VIP from January 1989 to December 2008. DATA SELECTION： A clinically randomized controlled study was used to evaluate safety and efficacy between anterior cervical decompression and fusion procedures as well as compound titanium rete implantation for the treatment of cervical spondylotic myelopathy. Control or vertebroplasty was excluded. MAIN OUTCOME MEASURES： JOA score, complication, and bone fusion rate. RESULTS： Six clinically control studies were included in the final analysis containing 443 patients. Among the patients, 190 cases were treated with anterior cervical decompression and fusion procedures alone, and 253 with anterior cervical decompression and fusion procedures as well as compound titanium rete implantation. All the 6 controls were performed with Meta analysis. ① Efficacy of anterior cervical decompression and fusion procedures as well as compound titanium rete implantation was superior to that of anterior cervical decompression and fusion procedures [OR=2.30, 95%, CI （1.32, 4.01）, P 〈 0.05]. ② Bone fusion rate of anterior cervical decompression and fusion procedures as well as compound titantium rete implantation was greater than anterior cervical decompression and fusion procedures [OR=3.61, 95%, CI （1.44, 9.08）, P 〈 0.05]. ③ Complications of anterior cervical decompression and fusion procedures as well as compound titanium rete implantation were less than anterior cervical decompression and fusion procedures [OR=0.08, 95%, CI （0.02, 0.30）, P 〈 0.05]. CONCLUSION： Evaluating results demonstrated that anterior cervical decompression and fusion procedures as well as compound titanium rete implantation was safe; additionally, clinical efficacy of anterior cervical decompression and fusion procedures as well as compound titanium rete implantation was superior to that of anterior cervical decompression and fusion procedures. However, the included samples were less in this study, and complications were reported rarely. Therefore, additional randomized controlled study characterizing by excellent design and methodology is needed for the further studies.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第35期6827-6830,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
