背景:我们进行了此网络荟萃分析,以全面比较不同节段的功效[中间节段(IS),短节段(SS)和长节段(LS)]在胸腰椎骨折的固定中。
方法:我们通过PubMed搜索了从开始到2023年1月20日的研究,Embase,WebofScience,还有Cochrane图书馆.该荟萃分析包括比较胸腰椎骨折不同节段固定的所有研究。结果是前椎体高度比(AVHR),矢状Cobb角(SCA),视觉模拟量表评分,和植入物故障率。该网络荟萃分析由带有gemtc软件包的R软件进行。
结果:最后,共有22项研究最终纳入本网络荟萃分析.就AVHR而言,IS(WMD2.43,95%CrI2.04-2.91)比SS更有效,差异有统计学意义。IS在降低SCA方面比LS更有效(WMD-2.87,95%CrI-3.79至-1.96),具有统计学意义。与SS相比,IS显著降低SCA,具有统计学意义(WMD-2.52,95%CrI-3.31至-1.72)。IS(WMD-2.87,95%CrI-3.78至-1.96)比LS更有效,差异有统计学意义。此外,IS(WMD-2.52,95%CrI-3.31至-1.72)比SS更有效,差异有统计学意义。
结论:IS与SCA的显著减少有关,植入物故障率,与SS和LS相比,视觉模拟量表,在所有评估的治疗中,对AVHR的影响最有利。
BACKGROUND: We did this network meta-analysis to comprehensively compare the efficacy of different segments [intermediate segment (IS), short segment (SS) and long segment (LS)] in the fixation of thoracolumbar fractures.
METHODS: We searched studies from inception until January 20, 2023 through PubMed, Embase, Web of Science, and the Cochrane Library. All studies comparing different segments in the fixation of thoracolumbar fractures were included in this meta-analysis. Outcomes were anterior vertebral height ratio (AVHR), sagittal Cobb angle (SCA), visual analogue scale score, and implant failure rate. This network meta-analysis was performed by R software with gemtc package.
RESULTS: Finally, a total of 22 studies were finally included in this network meta-analysis. IS (WMD 2.43, 95% CrI 2.04-2.91) was more effective than SS in terms of the AVHR, and the difference was statistically significant. IS was more effective than LS in reducing SCA (WMD -2.87, 95% CrI -3.79 to -1.96) with statistically significant. Compared with SS, IS significantly reduced the SCA with statistically significant (WMD -2.52, 95% CrI -3.31 to -1.72). IS (WMD -2.87, 95% CrI -3.78 to -1.96) was more effective than LS, and the difference was statistically significant. Moreover, IS (WMD -2.52, 95% CrI -3.31 to -1.72) was more effective than SS, and the difference was statistically significant.
CONCLUSIONS: IS was associated with a significant reduction in SCA, implant failure rate, and visual analogue scale compared to SS and LS, while having the most favorable impact on AVHR among all the treatments assessed.