PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to compare the clinical efficacy and safety of reduction vs. arthrodesis in situ with transforaminal lumbar interbody fusion (TLIF) for low-grade lumbar spondylolisthesis.
UNASSIGNED: Systematic review and meta-analysis.
UNASSIGNED: A comprehensive literature search was implemented in PubMed, Embase, and Cochrane Library databases. Randomized or non-randomized controlled trials that were published until July 2023 that compared reduction vs. arthrodesis in situ techniques with minimally invasive or open-TLIF for low-grade spondylolisthesis were selected. The quality of the included studies was evaluated by the Newcastle-Ottawa Scale (NOS). Data were extracted according to the predefined outcome measures, including operation time and intraoperative blood loss; short- and long-time follow-up of visual analog scale (VAS) back pain (VAS-BP) and Oswestry Disability Index (ODI); slippage and segmental lordosis; and the complication and fusion rate.
UNASSIGNED: Five studies (n = 495 patients) were finally included. All of them were retrospective cohort studies with Evidence Level II. The pooled data revealed that both techniques had similar patient-reported outcomes (VAS, ODI, and good and excellent rate) during short- and long-term follow-up. In addition, no significant differences were observed in the fusion and complication rates. However, although the reduction group did achieve better slippage correction, it was associated with increased operation time and intraoperative blood loss compared with the in situ arthrodesis group.
UNASSIGNED: Based on the available evidence, intraoperative reduction does not result in better clinical outcomes in low-grade spondylolisthesis after minimally invasive or open-TLIF, and the in situ arthrodesis technique could be an alternative.
UNASSIGNED: Systematic review and meta-analysis.
UNASSIGNED: A comprehensive literature search was implemented in PubMed, Embase, and Cochrane Library databases. Randomized or non-randomized controlled trials that were published until July 2023 that compared reduction vs. arthrodesis in situ techniques with minimally invasive or open-TLIF for low-grade spondylolisthesis were selected. The quality of the included studies was evaluated by the Newcastle-Ottawa Scale (NOS). Data were extracted according to the predefined outcome measures, including operation time and intraoperative blood loss; short- and long-time follow-up of visual analog scale (VAS) back pain (VAS-BP) and Oswestry Disability Index (ODI); slippage and segmental lordosis; and the complication and fusion rate.
UNASSIGNED: Five studies (n = 495 patients) were finally included. All of them were retrospective cohort studies with Evidence Level II. The pooled data revealed that both techniques had similar patient-reported outcomes (VAS, ODI, and good and excellent rate) during short- and long-term follow-up. In addition, no significant differences were observed in the fusion and complication rates. However, although the reduction group did achieve better slippage correction, it was associated with increased operation time and intraoperative blood loss compared with the in situ arthrodesis group.
UNASSIGNED: Based on the available evidence, intraoperative reduction does not result in better clinical outcomes in low-grade spondylolisthesis after minimally invasive or open-TLIF, and the in situ arthrodesis technique could be an alternative.
摘要：
■本研究旨在比较减少与减少的临床疗效和安全性原位关节固定术联合经椎间孔腰椎椎间融合术（TLIF）治疗低度腰椎滑脱。
■系统评价和荟萃分析。
■在PubMed中进行了全面的文献检索，Embase,和Cochrane图书馆数据库。截至2023年7月发表的随机或非随机对照试验，比较减少与选择微创或开放TLIF的关节固定术原位技术治疗低级别腰椎滑脱.采用纽卡斯尔-渥太华量表(NOS)评价纳入研究的质量。根据预定义的结果度量提取数据，包括手术时间和术中出血量；视觉模拟量表（VAS）背痛（VAS-BP）和Oswestry残疾指数（ODI）的短期和长期随访；滑脱和节段前凸；并发症和融合率。
■最终纳入了5项研究（n=495名患者）。所有这些都是具有II级证据的回顾性队列研究。汇总数据显示，两种技术的患者报告结果相似(VAS，ODI,以及良好和优良率)在短期和长期随访中。此外,在融合和并发症发生率方面没有观察到显著差异.然而,虽然复位组确实取得了更好的滑移校正，与原位关节融合术组相比，这与手术时间和术中失血量增加有关。
■根据现有证据，术中复位在微创或开放TLIF后低级别腰椎滑脱的临床效果不佳,原位关节固定术可能是一种替代方法。
■系统评价和荟萃分析。
■在PubMed中进行了全面的文献检索，Embase,和Cochrane图书馆数据库。截至2023年7月发表的随机或非随机对照试验，比较减少与选择微创或开放TLIF的关节固定术原位技术治疗低级别腰椎滑脱.采用纽卡斯尔-渥太华量表(NOS)评价纳入研究的质量。根据预定义的结果度量提取数据，包括手术时间和术中出血量；视觉模拟量表（VAS）背痛（VAS-BP）和Oswestry残疾指数（ODI）的短期和长期随访；滑脱和节段前凸；并发症和融合率。
■最终纳入了5项研究（n=495名患者）。所有这些都是具有II级证据的回顾性队列研究。汇总数据显示，两种技术的患者报告结果相似(VAS，ODI,以及良好和优良率)在短期和长期随访中。此外,在融合和并发症发生率方面没有观察到显著差异.然而,虽然复位组确实取得了更好的滑移校正，与原位关节融合术组相比，这与手术时间和术中失血量增加有关。
■根据现有证据，术中复位在微创或开放TLIF后低级别腰椎滑脱的临床效果不佳,原位关节固定术可能是一种替代方法。
