PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to evaluate the clinical outcomes, complication rate, feasibility, and applicability of transfacet pedicle-sparing approach for treating thoracic disc herniation.
METHODS: We searched three databases including the Cochrane Library, PubMed, and Embase for eligible studies until Dec 2022. The quality of studies and their risk of bias were assessed using the methodological index for non-randomized studies. We evaluated the heterogeneity between studies using the I2 statistic and the P-value for the heterogeneity.
RESULTS: A total of 328 patients described in 11 included articles were published from 2009 to 2022. Pain outcomes using the visual analog scale (VAS score) were reported in four studies. The standardized mean difference was reported as 0.749 (CI 95% 0.555-0.943). The obtained result showed the positive effect of the procedure and the improvement of patients\' pain after the surgery. Myelopathy outcomes using the Nurick score were reported in five studies. The standardized mean difference was reported as 0.775 (CI 95% 0.479-1.071). The result showed the positive effect of the procedure. Eight studies assessed postoperative complications and neurological deterioration. The pooled overall complication was 12.4% (32/258) and 3.5% (9/258) neurological worsening.
CONCLUSIONS: The results of this study demonstrated a positive effect of the transfacet pedicle-sparing approach on the clinical outcomes of patients with thoracic disc herniation surgery. The technique has been shown to be safe and effective for the right patient. The technique is associated with lower rates of complications and a shorter hospital stay compared to other surgical approaches. This information can assist clinicians in making informed decisions when selecting the most appropriate surgical technique for their patients with thoracic disc herniation.
METHODS: We searched three databases including the Cochrane Library, PubMed, and Embase for eligible studies until Dec 2022. The quality of studies and their risk of bias were assessed using the methodological index for non-randomized studies. We evaluated the heterogeneity between studies using the I2 statistic and the P-value for the heterogeneity.
RESULTS: A total of 328 patients described in 11 included articles were published from 2009 to 2022. Pain outcomes using the visual analog scale (VAS score) were reported in four studies. The standardized mean difference was reported as 0.749 (CI 95% 0.555-0.943). The obtained result showed the positive effect of the procedure and the improvement of patients\' pain after the surgery. Myelopathy outcomes using the Nurick score were reported in five studies. The standardized mean difference was reported as 0.775 (CI 95% 0.479-1.071). The result showed the positive effect of the procedure. Eight studies assessed postoperative complications and neurological deterioration. The pooled overall complication was 12.4% (32/258) and 3.5% (9/258) neurological worsening.
CONCLUSIONS: The results of this study demonstrated a positive effect of the transfacet pedicle-sparing approach on the clinical outcomes of patients with thoracic disc herniation surgery. The technique has been shown to be safe and effective for the right patient. The technique is associated with lower rates of complications and a shorter hospital stay compared to other surgical approaches. This information can assist clinicians in making informed decisions when selecting the most appropriate surgical technique for their patients with thoracic disc herniation.
摘要：
目的：本研究旨在评估临床结局，并发症发生率,可行性,经椎弓根保留入路治疗胸椎间盘突出症的适用性。
方法：我们搜索了三个数据库，包括Cochrane库，PubMed,和Embase的合格研究，直到2022年12月。使用非随机研究的方法学指标评估研究质量及其偏倚风险。我们使用I2统计量和P值评估了研究之间的异质性。
结果：从2009年到2022年，共发表了11篇纳入文章中描述的328例患者。在四项研究中报告了使用视觉模拟量表（VAS评分）的疼痛结果。标准化平均差异报告为0.749（CI95%0.555-0.943）。所获得的结果显示了手术的积极作用和术后患者疼痛的改善。5项研究报告了使用Nurick评分的脊髓病结局。标准化平均差异报告为0.775(CI95%0.479-1.071)。结果表明了该方法的积极作用。八项研究评估了术后并发症和神经系统恶化。合并的总并发症为12.4%（32/258）和3.5%（9/258）神经系统恶化。
结论：这项研究的结果表明，保留椎弓根的经切面入路对胸椎间盘突出症手术患者的临床结局具有积极作用。该技术已被证明对正确的患者是安全有效的。与其他手术方法相比，该技术的并发症发生率较低，住院时间较短。这些信息可以帮助临床医生在为胸椎间盘突出症患者选择最合适的手术技术时做出明智的决定。
方法：我们搜索了三个数据库，包括Cochrane库，PubMed,和Embase的合格研究，直到2022年12月。使用非随机研究的方法学指标评估研究质量及其偏倚风险。我们使用I2统计量和P值评估了研究之间的异质性。
结果：从2009年到2022年，共发表了11篇纳入文章中描述的328例患者。在四项研究中报告了使用视觉模拟量表（VAS评分）的疼痛结果。标准化平均差异报告为0.749（CI95%0.555-0.943）。所获得的结果显示了手术的积极作用和术后患者疼痛的改善。5项研究报告了使用Nurick评分的脊髓病结局。标准化平均差异报告为0.775(CI95%0.479-1.071)。结果表明了该方法的积极作用。八项研究评估了术后并发症和神经系统恶化。合并的总并发症为12.4%（32/258）和3.5%（9/258）神经系统恶化。
结论：这项研究的结果表明，保留椎弓根的经切面入路对胸椎间盘突出症手术患者的临床结局具有积极作用。该技术已被证明对正确的患者是安全有效的。与其他手术方法相比，该技术的并发症发生率较低，住院时间较短。这些信息可以帮助临床医生在为胸椎间盘突出症患者选择最合适的手术技术时做出明智的决定。
