摘要
目的:通过对前路减压Zero-p椎间融合器与传统钛板联合Cage内固定治疗退行性颈椎病疗效的相关文献进行分析,为临床抉择提供循证医学依据。方法:通过计算机全面检索Cochrane Library、PubMed、Medline、EMbase、维普(VIP)、中国知网(CNKI)、万方数据库2003年8月-2014年4月中所有Zero-p椎间融合器与传统钛板联合Cage融合内固定治疗退行性颈椎病的临床研究,并手工检索相关期刊与会议论文。按照纳入与排除标准选择试验、评价质量和提取有效数据,采用RevMan5.1软件进行Meta分析。结果:一共有5项研究,472例患者纳入到本系统评价。对手术前后JOA改善情况、术后早期及末次随访时吞咽困难合并效应量分析:前路减压Zero-p椎间融合器组手术前后JOA评分改善情况优于传统钛板联合Cage内固定组[WMD=0.49,95%CI(0.38,0.60),Z=2.08(P=0.04)];前路减压Zero-p椎间融合器组术后早期吞咽困难情况优于传统钛板联合Cage内固定组,[RR=0.76,95%CI(0.58,0.98),Z=2.10(P=0.04)];Zero-p椎间融合器组术后末次随访的吞咽困难情况也优于传统钛板联合Cage内固定组,[RR=0.19,95%CI(0.06,0.58),Z=2.92(P=0.004)]。结论:JOA评分改善情况,新型Zero-p椎间融合器优于传统治疗退行性颈椎病的前路钛板联合Cage内固定,并能有效地减少术后吞咽困难及其并发症,但由于缺乏长期随访,两者远期疗效有待进一步观察。
Objectives：The purpose of this meta-analysis was to compare the clinical effects between Zero-p implant and traditional plate combined with cage in treating cervical degenerative and provide clinicians with an evidence base for their clinical decision making.Methods：The following electronic databases were searched：such as Cochrane library,PubMed,Medline,EMBASE,VIP,CNKI and Wanfang.Conference posters and abstracts were also electronically searched.In accordance with the inclusion and exclusion criteria,selected test,evaluated quality and extracted valid data.Meta-analysis was performed by RevMan 5.1.Results：Five clinical trials involving 472 patients were included.For JOA reduction,Zero-p group is more effective than traditional plate combined with cage group[WMD =0.49,95% CI（0.38,0.60）,Z=2.08（P=0.0.04）].For early postoperative dysphagia,the pooled data showed that a significant difference between the Zero-p and traditional plate combined with cage groups.[RR =0.76,95% CI（0.58,0.98）,Z=2.10（P=0.0.04）].For dysphagia at last follow-up,Zero-p group also was more effective than traditional plate combined with cage group,[RR = 0.19,95% CI（0.06,0.58）,Z = 2.92（P=0.004）].Conclusion：Both the new Zero-p implant and traditional plate combined with cage have the satisfactory clinical effect,while Zero-p implant can effectively reduce postoperative dysphagia and its complications.However,owing to the lack of a long-term follow-up,its long-term efficacy remains unknown.
出处
《中国中医骨伤科杂志》
CAS
2015年第2期28-33,共6页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
上海市科学技术委员会科技支撑项目(12401902104)
上海市卫生系统优秀学科带头人培养项目(XBR2013104)
