椎间盘置换-1.docVIP

腰椎椎间盘置换与融合治疗的Meta-分析 陈凌云, 唐文,刘志礼，舒勇*, * 通讯作者 0791-8692529 E-mail:shuyong57@163.com 江西 南昌330006 摘 要 目的：系统评价腰椎间盘置换与腰椎融合术治疗腰椎间盘退行性疾病 (DDD)疗效及安全性的差异。方法: 计算机检索MEDLINE(1966~2009年12月)，荷兰医学文摘（EMbase1966~2009年12月)，Cochrane 图书馆（2009年第12期），Cochrane 协作网背痛专业试验数据库、中国生物医学文献数据库(CBM截止2009 年12月），CNKI（截止 2009年12月）等数据库中腰椎间盘置换术与椎体间融合术疗退变性腰椎病的随机、半随机对照研究文献，手工检索中文文献；由两名研究者独立的进行文献提取和严格的质量评价；这些文献中，实验组采用椎间盘置换术，而对照组采用融合术；采用Revman4.2软件进行Meta-分析。结果: 共纳入9个研究，包括1188名患者。Meta分析结果显示：手术平均出血量、手术后2年手术相关并发症、再手术率两组无统计学差异；手术时间、住院时间、术后2年VAS疼痛评分及ODI功能障碍指数腰椎间盘置换组优于椎体间融合组。结论 本研究结果显示，腰椎间盘置换与传统腰椎融合术相比，腰椎间盘置换术近期疗效优于腰椎融合术；但手术安全性两者无显著差异。远期疗效有待高质量大样本长期随访的RCT进一步验证。关键词 : Meta-分析；系统评价；腰椎间盘置换；融合 Systematic review of lumbar disc replacement versus fusion Chen ling-yun, Tang wen，Liu Zhi-li,Shu Yong* Department of Orthopaedics，The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China，330006 *Corresponding author: Shu Yong,Email: shuyong57@163.com 【Abstract】 Objective: To assess the effect and the safety of lumbar disc replacement versus fusion for the treatment of degenerative disc disease (DDD).Methods : We conducted electronic database, identified randomized controlled trials (RCT) and some well designed clinical trails from Cochrane Back Group, the Cochrane library, additional electronic database including Medline、Embase 、CBM、CNKI ,we also searched some Chinese Journals manually, and contacted manufacturers and researchers in the field。Data were extracted and evaluated by two reviewers independently of each other；Among them ,the test group treated with artificial disc replacement ,while control group with fusion; The Cochrane Collaboration’s RevMan 4.2.8 software was used for data analyses. Results：9 studies including a total of 1188 patients met with the enrolling criteria for the study，Meta-analysis indicated that no difference was found in the mean operation time、mean blood loss、mean hospital stay、re-operation rate、device success rate between two groups. the disc replacement group has lo