背景:退变性脊椎滑脱是一种特征为椎骨在下方椎骨上方移位的疾病。由于使用了各种方法和技术,因此腰椎关节固定术是目前最常进行的手术治疗选择。这种疾病的特点是腰背痛,临床和公共卫生问题,除了有社会经济负担,严重影响功能状态,生活质量,活动损害,和卫生服务。这项研究旨在调查好处,在疼痛方面,残疾,和生活质量,退行性腰椎滑脱患者的腰椎关节固定术,在最新的后续行动中。
方法:ology:在PROSPERO注册的系统文献综述(ID:CRD42022379242),在Cochrane图书馆的数据库中进行,PubMed,Embase,Scopus,和Web的科学。使用的关键词是:“脊椎前移”,“关节固定术”,\"退化\",“生活质量”,\"痛苦\",“患者报告的结果”,\"残疾\"。
结果:共纳入26篇。在术前和术后评估考虑的结果之间发现显着差异,特别是:疼痛(MD=-6.74;SD=2.83;95CI:-8.01;-5.46),下腰痛(MD=-3.35;SD=3.27;95CI:-3.61;-3.10),下肢疼痛(MD=-3.81;SD=3.80;95CI:-4.10;-3.51),残疾(MD=-23.75;SD=19.68;95CI:-25.26;-22.23)和生活质量(MD=0.21;SD=0.24;95CI:0.19;0.23)。
结论:s:结果显示所有测量变量均有显着改善,证明有不同的手术治疗方法可以治愈退行性腰椎滑脱。然而,影响生活质量的残余疼痛仍然存在,不管使用的技术。因此,指出了针对残留慢性疼痛患者的个性化疼痛管理的发展。
BACKGROUND: Degenerative spondylolisthesis is a disease characterized by the displacement of a vertebra above the underlying vertebra. Lumbar arthrodesis is currently the most frequently performed surgical option for treatment due to the use of various approaches and techniques. The disease is characterized by low back pain, a clinical and public health problem, which in addition to having a socio-economic burden, severely affects functional status, quality of life (QoL), activity impairment, and health services. The study aims to investigate the benefits, in terms of pain, disability, andQoL, of lumbar arthrodesis surgery in patients with degenerative spondylolisthesis, at the latest follow-up.
METHODS: A systematic literature
review registered in PROSPERO (ID: CRD42022379242), was conducted in the databases of: Cochrane Library, PubMed, Embase, Scopus, and Web of Science. The key words used were as follows: \"spondylolisthesis\", \"arthrodesis\", \"degenerative\", \"quality of life\", \"pain\", \"patient reported outcome\", and \"disability\".
RESULTS: A total of 26 articles were included. Significant differences were found between the preoperative and postoperative evaluation of the outcomes considered, in particular: pain (MD = -6.74; SD = 2.83; 95% CI: -8.01 to -5.46), low back pain (MD = -3.35; SD = 3.27; 95% CI: -3.61 to -3.10), lower limb pain (MD = -3.81; SD = 3.80; 95% CI: -4.10 to -3.51), disability (MD = -23.75; SD = 19.68; 95% CI: -25.26 to -22.23) and QoL (MD = 0.21; SD = 0.24; 95% CI: 0.19 to 0.23).
CONCLUSIONS: The results show significant improvement in all measured variables, demonstrating that there are different surgical treatments to cure degenerative spondylolisthesis. However, residual pain impacting the QoL remains, regardless of the technique used. Therefore, the development of personalized pain management for patients with residual chronic pain is indicated.