Abstract：
METHODS: Systematic Review and Meta-analysis.
OBJECTIVE: This systematic review and meta-analysis is aimed to assess effectiveness, safety, clinical, functional and radiological outcome of either combined anteroposterior or posterior-only approach in the surgical management of active tubercular disease of paediatric thoracolumbar spine.
METHODS: A systematic literature search through PubMed, Scopus, Web of Science and Cochrane Library database was performed. Data extraction was undertaken following methodological quality assessment.
RESULTS: 9 out of the 182 publications identified, were included for analysis. A total of 247 patients were analysed. Two amongst the 9 studies were retrospective comparative studies evaluating posterior approach with combined anteroposterior approach and were considered for comparative meta-analysis. Blood loss and duration of surgery was significantly higher in the anteroposterior group, as compared to the posterior-only group. There was no significant difference between the 2 groups in terms of post-operative kyphosis angles, final kyphosis angles, number of complications, functional outcome and spinal fusion time. However, all the included studies were non-randomised and retrospective. Only 2 of them had a control group with a high heterogeneity amongst these 2 studies.
CONCLUSIONS: The inference from the studies included in this review suggests that equivalent results can be achieved with posterior-only approach for thoracolumbar tuberculosis in children as compared to anteroposterior approach, with much lower complexity, reduced blood loss and shorter surgical time. However, due to the high risk of bias and considerable heterogeneity among the studies included, we cannot conclude whether one approach is better than the other.
OBJECTIVE: This systematic review and meta-analysis is aimed to assess effectiveness, safety, clinical, functional and radiological outcome of either combined anteroposterior or posterior-only approach in the surgical management of active tubercular disease of paediatric thoracolumbar spine.
METHODS: A systematic literature search through PubMed, Scopus, Web of Science and Cochrane Library database was performed. Data extraction was undertaken following methodological quality assessment.
RESULTS: 9 out of the 182 publications identified, were included for analysis. A total of 247 patients were analysed. Two amongst the 9 studies were retrospective comparative studies evaluating posterior approach with combined anteroposterior approach and were considered for comparative meta-analysis. Blood loss and duration of surgery was significantly higher in the anteroposterior group, as compared to the posterior-only group. There was no significant difference between the 2 groups in terms of post-operative kyphosis angles, final kyphosis angles, number of complications, functional outcome and spinal fusion time. However, all the included studies were non-randomised and retrospective. Only 2 of them had a control group with a high heterogeneity amongst these 2 studies.
CONCLUSIONS: The inference from the studies included in this review suggests that equivalent results can be achieved with posterior-only approach for thoracolumbar tuberculosis in children as compared to anteroposterior approach, with much lower complexity, reduced blood loss and shorter surgical time. However, due to the high risk of bias and considerable heterogeneity among the studies included, we cannot conclude whether one approach is better than the other.
摘要：
方法：系统评价和Meta分析。
目的：本系统综述和荟萃分析旨在评估有效性，安全,临床,在小儿胸腰段脊柱活动性结核疾病的外科治疗中，前后路或仅后路联合入路的功能和放射学结果。
方法：通过PubMed进行系统的文献检索，Scopus,进行了WebofScience和Cochrane图书馆数据库。数据提取是在方法学质量评估之后进行的。
结果：确定的182种出版物中有9种，被纳入分析。共分析了247例患者。9项研究中有2项是回顾性比较研究，评估后路与前后路联合入路，并考虑进行比较荟萃分析。前后组的失血量和手术持续时间明显较高，与仅后部组相比。2组术后后凸角度差异无统计学意义,最终后凸角度,并发症的数量，功能结果和脊柱融合时间。然而,所有纳入的研究均为非随机和回顾性研究.在这2项研究中，只有2项具有高异质性的对照组。
结论：从本综述中纳入的研究中得出的结论表明，与前后入路相比，仅使用后路入路治疗儿童胸腰椎结核可获得相同的结果。复杂性要低得多，减少失血，缩短手术时间。然而,由于纳入的研究存在较高的偏倚风险和相当大的异质性，我们无法断定一种方法是否比另一种方法更好。
目的：本系统综述和荟萃分析旨在评估有效性，安全,临床,在小儿胸腰段脊柱活动性结核疾病的外科治疗中，前后路或仅后路联合入路的功能和放射学结果。
方法：通过PubMed进行系统的文献检索，Scopus,进行了WebofScience和Cochrane图书馆数据库。数据提取是在方法学质量评估之后进行的。
结果：确定的182种出版物中有9种，被纳入分析。共分析了247例患者。9项研究中有2项是回顾性比较研究，评估后路与前后路联合入路，并考虑进行比较荟萃分析。前后组的失血量和手术持续时间明显较高，与仅后部组相比。2组术后后凸角度差异无统计学意义,最终后凸角度,并发症的数量，功能结果和脊柱融合时间。然而,所有纳入的研究均为非随机和回顾性研究.在这2项研究中，只有2项具有高异质性的对照组。
结论：从本综述中纳入的研究中得出的结论表明，与前后入路相比，仅使用后路入路治疗儿童胸腰椎结核可获得相同的结果。复杂性要低得多，减少失血，缩短手术时间。然而,由于纳入的研究存在较高的偏倚风险和相当大的异质性，我们无法断定一种方法是否比另一种方法更好。
