| Objective To compare the clinical efficacy of anterior approach vs. posterior approach fixation fusion in the treatment of Lenke 1 type adolescent idiopathic scoliosis. Methods The literatures related to anterior and posterior internal fixation fusion therapy for Lenke 1 type adolescent idiopathic scoliosis from CNKI, Wanang Database, PubMed, Web of Science and Cochrane Library. Extraction from the literature included main curve degree, operation time, intraoperative blood loss, length of hospital stay, fusion segment, postoperative complications. The included studies were analyzed using RevMan 5.4 software. Results In the end, 7 references were included, all in English, with a total of 388 patients, including 207 patients with anterior approach and 181 patients with posterior approach. The anterior approach group was superior to the posterior approach group in terms of thoracic kyphosis ［WMD=-6.81, 95% CI (-10.33, -2.02), P＜0.05］, fusion segment ［WMD=-2.98, 95% CI (-4.29, -1.66), P＜0.05］, intraoperative blood loss ［WMD=-616.04, 95% CI (-1 082.93, -149.15), P＜0.05］. However, the posterior approach group had more advantages in operation time ［WMD=96.75, 95% CI (56.74, 136.76), P＜0.05］, postoperative complications ［RR=2.68, 95% CI (1.67, 4,31), P＜0.0001］. Conclusion Both anterior and posterior surgery can achieve the correction of coronal deformities. Anterior approach can reduce fusion segments, reduce intraoperative blood loss, and maintain better thoracic kyphosis. Especially, it can meet the aesthetic requirements under the assistance of thoracoscopy. However, the posterior approach is still a classic treatment strategy with a shorter operation time and fewer complications, and the surgical plan should be carefully selected according to the condition and the patient's demands. Due to the limitation of quantity and quality of literature, the above conclusions need to be verified by more high-quality studies. |
