Abstract：
METHODS: Systematic review.
OBJECTIVE: To compare the efficacy of the posterior approach and combined anterior-posterior approach in the treatment of ankylosing spondylitis (AS) with cervical spine fracture by meta-analysis.
METHODS: The databases PubMed, Web of Science, Embase, and Cochrane Library were searched for studies on the comparison of the posterior approach group and the combined anterior-posterior approach group in the treatment of ankylosing spondylitis combined with cervical spine fracture from database establishment to August 2023. The procedure time, intraoperative blood loss, the rates of neurological improvement, mean change in the postoperative neurological function, complication rates, rates of revised surgery, and mortality were extracted. Meta-analysis was performed using RevMan 5.4 software provided by Cochrane Library.
RESULTS: A total of 11 retrospective cohort studies with a total of 215 patients were included in this study. The posterior approach group had lower intraoperative blood loss than the combined anterior-posterior approach group [Mean difference (MD) = -146.05, 95%CI(-187.40,-104.69), P < .00001]; the operation time was significantly less in the posterior approach group than in the combined anterior-posterior approach group [MD = -95.34, 95%CI(-113.13,-77.55), P < .00001]. There were no statistically significant differences in the neurological improvement rates, mean changes in postoperative neurological function, complication rates, modified surgery rates, and mortality rates.
CONCLUSIONS: Both the posterior approach and combined anterior and posterior approach can achieve good results. Clinicians should develop an individualized approach based on the patient\'s fracture type, degree of spinal cord injury, fracture stability, fracture dislocation, general condition, and underlying disease.
OBJECTIVE: To compare the efficacy of the posterior approach and combined anterior-posterior approach in the treatment of ankylosing spondylitis (AS) with cervical spine fracture by meta-analysis.
METHODS: The databases PubMed, Web of Science, Embase, and Cochrane Library were searched for studies on the comparison of the posterior approach group and the combined anterior-posterior approach group in the treatment of ankylosing spondylitis combined with cervical spine fracture from database establishment to August 2023. The procedure time, intraoperative blood loss, the rates of neurological improvement, mean change in the postoperative neurological function, complication rates, rates of revised surgery, and mortality were extracted. Meta-analysis was performed using RevMan 5.4 software provided by Cochrane Library.
RESULTS: A total of 11 retrospective cohort studies with a total of 215 patients were included in this study. The posterior approach group had lower intraoperative blood loss than the combined anterior-posterior approach group [Mean difference (MD) = -146.05, 95%CI(-187.40,-104.69), P < .00001]; the operation time was significantly less in the posterior approach group than in the combined anterior-posterior approach group [MD = -95.34, 95%CI(-113.13,-77.55), P < .00001]. There were no statistically significant differences in the neurological improvement rates, mean changes in postoperative neurological function, complication rates, modified surgery rates, and mortality rates.
CONCLUSIONS: Both the posterior approach and combined anterior and posterior approach can achieve good results. Clinicians should develop an individualized approach based on the patient\'s fracture type, degree of spinal cord injury, fracture stability, fracture dislocation, general condition, and underlying disease.
摘要：
方法：系统评价。
目的：通过Meta分析比较后路入路与前后路联合入路治疗强直性脊柱炎(AS)伴颈椎骨折的疗效。
方法：数据库PubMed，WebofScience,Embase,从数据库建立到2023年8月，通过Cochrane图书馆检索后入路组和前后联合入路组治疗强直性脊柱炎合并颈椎骨折的比较研究。手术时间,术中失血,神经系统的改善率，术后神经功能的平均变化，并发症发生率,修正手术率，和死亡率被提取。采用CochraneLibrary提供的RevMan5.4软件进行Meta分析。
结果：本研究共纳入11项回顾性队列研究，共215例患者。后入路组的术中出血量低于前后入路组[平均差异（MD）=-146.05，95CI（-187.40，-104.69），P<.00001]；后入路组的手术时间明显少于前后入路联合组[MD=-95.34，95CI（-113.13，-77.55），P<.00001].神经系统改善率无统计学差异，术后神经功能的平均变化，并发症发生率,修改手术率，和死亡率。
结论：后路入路和前后路联合入路均能取得良好的效果。临床医生应根据患者的骨折类型制定个性化的治疗方法，脊髓损伤程度,断裂稳定性,骨折脱位,一般情况,和潜在的疾病。
目的：通过Meta分析比较后路入路与前后路联合入路治疗强直性脊柱炎(AS)伴颈椎骨折的疗效。
方法：数据库PubMed，WebofScience,Embase,从数据库建立到2023年8月，通过Cochrane图书馆检索后入路组和前后联合入路组治疗强直性脊柱炎合并颈椎骨折的比较研究。手术时间,术中失血,神经系统的改善率，术后神经功能的平均变化，并发症发生率,修正手术率，和死亡率被提取。采用CochraneLibrary提供的RevMan5.4软件进行Meta分析。
结果：本研究共纳入11项回顾性队列研究，共215例患者。后入路组的术中出血量低于前后入路组[平均差异（MD）=-146.05，95CI（-187.40，-104.69），P<.00001]；后入路组的手术时间明显少于前后入路联合组[MD=-95.34，95CI（-113.13，-77.55），P<.00001].神经系统改善率无统计学差异，术后神经功能的平均变化，并发症发生率,修改手术率，和死亡率。
结论：后路入路和前后路联合入路均能取得良好的效果。临床医生应根据患者的骨折类型制定个性化的治疗方法，脊髓损伤程度,断裂稳定性,骨折脱位,一般情况,和潜在的疾病。
