plif与tlif治疗成人腰椎滑脱症疗效对比的meta研究word论文.docxVIP

PLIF与TLIF治疗成人腰椎滑脱症疗效对比的Meta分析摘要目的：均有大量文献报道PLIF和TLIF两种方法治疗成人腰椎滑脱症获得了满意的疗效，但哪种方法更具优势尚缺乏文献报道。收集文献资料，采用Meta分析的方法对比研究PLIF和TLIF两种方法治疗成人腰椎滑脱症的疗效，为临床决策提供证据。方法：在PUBMED、MEDLINE、CNKI及CochraneCollaborationLibrary 数据库中检索自1950 年至2015 年2 月的随机对照试验（RCTs,relevantrandomizedcontrolled trials）和观察对照研究。按照纳入排除标准对文献进行筛选，对研究涉及的主要结局指标文献中应有详细的数据结果。按照Grade指南对文献中的证据进行质量评估。结果：经检索没有符合标准的随机对照试验，最后共纳入5篇对照研究文献。PLIF 组和TLIF组在临床满意度中无显著性差异(OR=0.94;95%CI=0.54-1.61;P=0.81)。PLIF组和TILF组的满意率分别为83.0%和83.9%。在PLIF组和TLIF组之间，手术并发症发生率存无显著性差异(OR=4.67; 95%CI=0.46-47.63; P=0.10)。并发症的发生率在两组中分别为8.29%和2.73%。PLIF组和TLIF组的融合率分别为98.3%和98.4%。两组间的融合率无统计学差异(OR=1.15;95%CI=0.21-6.20; P=0.87)。来自其中两个研究的融合率两组均为100%，另外两个研究中PLIF组和TLIF组的融合率分别为91.7%和96.7%。结论：PLIF和TLIF在治疗成人腰椎滑脱症中的临床满意度、围手术期并发症发生率、I融合率均无统计学差异，两种方法均能较好地缓解患者腰痛、腿疼、间歇性跛行等症状，可以认为PLIF和TLIF对于成人腰椎滑脱症的治疗具有相同的优势。但本次meta分析纳入文献较少、纳入病例数较少，证据质量等级较低，对这一结果应谨慎解读。关键词：meta分析；腰椎融合；经后路椎体间融合；经椎间孔椎体间融合；腰椎滑脱症WhatistheOptimumFusionTechniqueforAdultSpondylolisthesis:PLIForTLIF?AMeta-analysisFrom5ComparativeStudiesAbstractObjective:Both of tow methods havebeen reportedeffectivelyin manystudies. However, which is thebetter oneisin dispute.This is ameta-analysis.Tocollect evidenceforthe optimum selection in thetreatment of adult lumbarspondylolisthesis by comparingthe clinical outcomes ofposteriorlumbar interbodyfusion (PLIF) and transforaminal lumbar interbodyfusion (TLIF).Methods:AsystematicsearchwasdidinPUBMED,MEDLINE,CNKI,andtheCochrane CollaborationLibraryfrom1950throughFebruary2015.Studieswereenrolledbasedon the studyeligibilitycriteria.Results:Fiveobservationalstudieswereeligible.Nosignificantdifferencesintheclinical satisfactionwereseenbetweenPLIFandTLIF(OR=0.94;95%CI=0.54-1.61;P=0.81). Forthecomplicationrate,thedifferenceswerenosignificantbetweenPLIFandTLIF (OR=4.67;95%CI=0.46-47.63;P=0.10).Andthereisnosignificantdifferencesinthe fusion rate between PLIFandTLIF (OR=1.15; 95%CI=0.21-6.20; P=0.87).Conclusion:PLIFandTLIFhavethesameadvantageforthetreatmentofadultlumbar spondylolisthesis.Bothofth