| 梁伟时,海涌,韩渤,等.前路与后路选择性融合治疗Lenke 5型青少年特发性脊柱侧凸的Meta分析研究.骨科,2023,14(1): 27-33. |
| 前路与后路选择性融合治疗Lenke 5型青少年特发性脊柱侧凸的Meta分析研究 |
| Anterior versus Posterior Spinal Selective Fusion Approaches in Treating Lenke Type 5 Adolescent Idiopathic Scoliosis: A Meta-Analysis |
| 投稿时间：2022-12-31 |
| DOI：10.3969/j.issn.1674-8573.2023.01.007 |
| 中文关键词: 青少年特发性脊柱侧弯 Lenke 5型 前路脊柱融合术 后路脊柱融合术 Meta分析 |
| 英文关键词: Adolescent idiopathic scoliosis Lenke type 5 Anterior spinal fusion Posterior spinal fusion Meta-analysis |
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| 中文摘要: |
| 目的 比较选择性前路脊柱融合术（anterior spinal fusion，ASF）和后路脊柱融合术（posterior spinal fusion，PSF）治疗Lenke 5型青少年特发性脊柱侧凸（adolescent idiopathic scoliosis，AIS）的影像学和临床指标差异。方法 在PubMed、Embase、Cochrane Library、Web of Science四个文献数据库进行系统文献检索。采用Meta分析的方法比较ASF与PSF治疗后胸腰/腰弯、胸弯的矫正度数及其他重要影像学和临床指标的变化。结果 本研究共纳入15项研究，包括505例ASF病人和467例PSF病人。PSF组的术后胸弯代偿性矫正度数明显大于ASF组，差异有统计学意义（P＜0.05），但两组末次随访时的数据未见明显差异（P＞0.05）。ASF与PSF组在术后和末次随访时的胸腰/腰弯矫正度数、末次随访时的躯干偏移距离及术中出血量比较，差异均无统计学意义（P＞0.05）。与PSF组比较，ASF组的融合节段较少，但手术时间较长，组间比较，差异有统计学意义（P＜0.05）。结论 在长期随访过程中，ASF具有与PSF相似的冠状位弯曲和平衡的矫正效果，且融合节段较少。医生应根据病人畸形的严重程度和手术技术水平，选择合适的手术入路。 |
| 英文摘要: |
| Objective To compare the radiographical and clinical outcomes between selective anterior spinal fusion (ASF) and posterior spinal fusion (PSF) in Lenke type 5 adolescent idiopathic scoliosis (AIS). Methods A systematic literature search was conducted in PubMed, Embase, Cochrane Library and Web of Science for relevant studies. Correction degree of thoracolumbar/lumbar (TL/L) and thoracic curves, along with other essential radiographical and clinical outcomes between ASF and PSF, were compared in the meta-analysis. Results A total of 505 ASF patients and 467 PSF patients from 15 studies were included. The ASF group showed more postoperative compensatory correction degree of the thoracic curve than the PSF group (P＜0.05), however, no statistically significant differences were found at the final follow-up (P＞0.05). There was no significant difference in the correction degree of TL/L curves at the post-operation and at the final follow-up, trunk shift (TS) distance at the final follow-up and the blood loss between ASF and PSF (P＞0.05). Moreover, ASF showed fewer fusion segments but longer operation time (P＜0.05). Conclusion ASF could achieve an approximate correction effect of coronal curve and balance as PSF with fewer fusion segments in long-term follow-up. The surgeons should choose the appropriate surgical approach according to the severity of the patient's deformity and the surgical technique level. |
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