PDF(Pubmed)
Abstract：
This study presents a systematic literature review and meta-analysis of pseudarthrosis risk factors following lumbar fusion procedures. The odds ratio (OR) and 95% confidence interval (95% CI) were used for outcome measurements. The objective of this study was to identify the independent risk factors for pseudarthrosis after lumbar spinal fusion, which is crucial for mitigating morbidity and reoperation. Systematic searches in PubMed, Embase, and Scopus (1990-July 2021) were conducted using specific terms. The inclusion criteria included prospective and retrospective cohorts and case‒control series reporting ORs with 95% CIs from multivariate analysis. The quality assessment utilized the Newcastle-Ottawa scale. Meta-analysis, employing OR and 95% CI, assessed pseudarthrosis risk factors in lumbar fusion surgery, depicted in a forest plot. Of the 568 abstracts identified, 12 met the inclusion criteria (9 retrospective, 2006-2021). The 17 risk factors were categorized into clinical, radiographic, surgical, and bone turnover marker factors. The meta-analysis highlighted two significant clinical risk factors: age (95% CI 1.02-1.11; p = 0.005) and smoking (95% CI 1.68-5.44; p = 0.0002). The sole significant surgical risk factor was the number of fused levels (pooled OR 1.35; 95% CI 1.17-1.55; p < 0.0001). This study identified 17 risk factors for pseudarthrosis after lumbar fusion surgery, emphasizing age, smoking status, and the number of fusion levels. Prospective studies are warranted to explore additional risk factors and assess the impact of surgery and graft type.
摘要：
这项研究提供了腰椎融合手术后假关节危险因素的系统文献综述和荟萃分析。比值比(OR)和95%置信区间(95%CI)用于结果测量。这项研究的目的是确定腰椎融合术后假关节的独立危险因素，这对于降低发病率和再次手术至关重要。PubMed中的系统搜索，Embase,和Scopus(1990-2021年7月)使用特定术语进行。纳入标准包括前瞻性和回顾性队列以及病例对照系列报告OR，其中95%CI来自多变量分析。质量评估采用了纽卡斯尔-渥太华量表。Meta分析,采用OR和95%CI，评估腰椎融合手术假关节的危险因素，在森林情节中描绘。在确定的568份摘要中，12项符合纳入标准(9项回顾性，2006-2021)。将17个危险因素分为临床，射线照相,外科,和骨转换标记因子。荟萃分析强调了两个重要的临床危险因素：年龄（95％CI1.02-1.11；p=0.005）和吸烟（95％CI1.68-5.44；p=0.0002）。唯一显著的手术风险因素是融合水平的数量(合并OR1.35;95%CI1.17-1.55;p<0.0001)。这项研究确定了腰椎融合术后假关节的17个危险因素，强调年龄，吸烟状况,和融合级别的数量。有必要进行前瞻性研究以探索其他风险因素并评估手术和移植物类型的影响。
