| 颈椎前路与后路手术治疗多节段脊髓型颈椎病疗效的Meta分析 |
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Received:March 15, 2006
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| 作者 | Author | 单位 | Unit | E-Mail |
| 游景扬 |
YOU Jing-yang |
咸宁市中心医院 湖北科技学院附属第一医院创伤骨科, 湖北 咸宁 437100 |
Department of Trauma Orthopaedics, the First Hospital Affiliated to Sciecne and Techenque College of Hubei, Xianning 437100, Hubei, China |
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| 郑勇 |
ZHENG Yong |
咸宁市中心医院 湖北科技学院附属第一医院创伤骨科, 湖北 咸宁 437100 |
Department of Trauma Orthopaedics, the First Hospital Affiliated to Sciecne and Techenque College of Hubei, Xianning 437100, Hubei, China |
fansir00.@163.com |
| 陈明 |
CHEN Ming |
咸宁市中心医院 湖北科技学院附属第一医院创伤骨科, 湖北 咸宁 437100 |
Department of Trauma Orthopaedics, the First Hospital Affiliated to Sciecne and Techenque College of Hubei, Xianning 437100, Hubei, China |
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| 范江荣 |
FAN Jiang-rong |
咸宁市中心医院 湖北科技学院附属第一医院创伤骨科, 湖北 咸宁 437100 |
Department of Trauma Orthopaedics, the First Hospital Affiliated to Sciecne and Techenque College of Hubei, Xianning 437100, Hubei, China |
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| 期刊信息：《中国骨伤》2017年30卷，第1期，第71-78页 |
| DOI：10.3969/j.issn.1003-0034.2017.01.017 |
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目的：系统评价颈椎前路与后路手术治疗多节段脊髓型颈椎病的疗效与安全性。
方法：计算机检索Cochrane图书馆（2015年第7期），PubMed（1966年至2015年12月），EMbase（1966年至2015年12月），OVID（1950年至2015年12月），万方数据库（1998年至2015年12月），中国期刊全文数据库（1999年至2015年12月），中国生物医学文献数据库（1978年至2015年12月），手工检索《中华骨科杂志》《中国脊柱脊髓杂志》等相关杂志，收集颈椎前路与后路手术治疗多节段脊髓型颈椎病的随机或半随机对照试验，由2名评价者按纳入与排除标准筛选试验、质量评价和提取资料后，采用RevMan 5.2软件进行Meta分析。
结果：最终纳入17个对照试验，共1 151例患者。Meta分析结果显示：前路手术与后路手术的术后并发症发生率[OR=2.19，95% CI（1.50，3.19），P<0.000 1]和神经功能改善率[WMD=11.04，95% CI（0.60，21.47），P=0.04]的差异有统计学意义；而手术时间[WMD=39.43，95% CI（-5.92，84.78），P=0.09]，术中出血量[WMD=5.46，95% CI（-96.65，107.58），P=0.92]，术前JOA评分[WMD=0.13，95% CI（-0.20，0.46），P=0.44]，术后JOA评分[WMD=0.45，95% CI（-0.10，1.00），P=0.11]的差异无统计学意义。
结论：颈椎前路手术与后路手术治疗多节段脊髓型颈椎病在脊髓神经功能改善、手术时间、术中出血量方面无显著差异，但后路手术在减少并发症方面明显优于前路手术。 |
| [关键词]:颈椎病 外科手术 治疗结果 Meta分析 |
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| Anterior versus posterior approach for multilevel cervical spondylotic myelopathy: a meta-analysis |
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Abstract:
Objective: To assess the clinical effectiveness and safety of anterior versus posterior approach for multilevel cervical spondylotic myelopathy.
Methods: The following databases were searched:the Cochrane Library, PubMed, EM base, OVID, CBM, Wanfang Data, CNKI.Relevant journals were manually searched for randomized controlled trials or clinical controlled trials (CCTs) that investigated the clinical effectiveness and safety of anterior and posterior approach for multilevel cervical spondylotic myelopathy.Two reviewers independently screened the literature according to inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of included studies.Meta-analysis was performed by using RevMan 5.2 software.
Results: Eight CCTs, involving 1 151 patients, were included.Significant differences were found between anterior and posterior approach with respect to complications, OR=2.19, 95% CI (1.50, 3.19), P<0.000 1;and neural recovery rate, WMD=11.04, 95% CI (0.60, 21.47), P=0.04.In addition, there were no significant differences in preoperative JOA scores, WMD=0.13, 95% CI (-0.20, 0.46), P=0.44;postoperative JOA scores, WMD=0.45, 95% CI (-0.10, 1.00), P=0.11;operation time, WMD=39.43, 95% CI (-5.92, 84.78), P=0.09;and amount of intraoperative bleeding, WMD=5.46, 95% CI (-96.65, 107.58), P=0.92).
Conclusion: There are no significant differences between anterior and posterior approach for multilevel cervical spondylotic myelopathy in the recovery of neural function of the spinal cord, operation time and intraoperative bleeding.However, posterior appreach showed fewer complications than anterior appreach. |
| KEYWORDS:Cervical spondylosis Surgical procedures,operative Treatment outcome Meta analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 游景扬,郑勇,陈明,范江荣.颈椎前路与后路手术治疗多节段脊髓型颈椎病疗效的Meta分析[J].中国骨伤,2017,30(1):71~78 |
| 英文格式: | YOU Jing-yang,ZHENG Yong,CHEN Ming,FAN Jiang-rong.Anterior versus posterior approach for multilevel cervical spondylotic myelopathy: a meta-analysis[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(1):71~78 |
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