UNASSIGNED:对于胸腰椎爆裂骨折(TBFs)的手术入路,选择前入路还是后入路一直存在争议。本研究旨在系统评价前后入路治疗TBFs的疗效和安全性。
UNASSIGNED:多个数据库,包括PubMed,摘录Medica数据库(Embase),科克伦图书馆,和WebofScience(WOS)被用来搜索相关研究,即比较前、后入路治疗TBFs的全文文章,根据人口,干预,control,结果,和研究(PICOS)框架。ReviewManager5.4用于评估选定研究中结果的影响。使用纽卡斯尔渥太华量表(NOS)和CochraneCollaboration的工具评估试验的偏倚风险。还为所包含的文章生成了森林地块和漏斗图。
未经评估:最后,723名患者被纳入13项符合资格标准的研究,漏斗图和Egger检验表明,出版物中没有明显的偏差。住院时间没有差异[平均差(MD):-1.31,(-5.31,2.69);P=0.52],住院费用[标准化平均差(SMD):1.26,(-0.38,2.89);P=0.13],并在前路和后路之间恢复工作。然而,后入路具有较好的Cobb角矫正效果[MD:2.06,(0.17,3.94);P=0.03],手术时间较短[MD:58.29,(35.39,81.18);P<0.00001],和较低的估计失血[MD:185.92,(131.76,240.07);P<0.00001]。
UNASSIGNED:在TBFs的治疗中,后入路似乎优于前入路。然而,应开展更多高质量的随机对照试验,以证实本研究的结论并指导临床决策.
UNASSIGNED: There has always been controversy about the choice of anterior approach or
posterior approach for the surgical approach of thoracolumbar burst fractures (TBFs). The aim of this study was to systematically evaluate the efficacy and safety of anterior and
posterior approaches in the treatment of TBFs.
UNASSIGNED: Multiple databases including PubMed, Excerpt Medica Database (Embase), Cochrane Library, and Web of Science (WOS) were used to search for relevant studies, namely full-text articles comparing the anterior versus
posterior approach for the treatment of TBFs, which based on population, intervention, control, outcome, and study (PICOS) framework. Review Manager 5.4 was used to assess the effects of the results among selected studies. The risk of bias of the trials was assessed using the Newcastle Ottawa scale (NOS) and the Cochrane Collaboration\'s tool. Forest plots and funnel plots were also generated for the included articles.
UNASSIGNED: Finally, 723 patients were included in 13 studies which satisfied the eligibility criteria, funnel plots and Egger\'s test showed that there was no significant bias in the publications. There were no differences in terms of length of stay [mean difference (MD): -1.31, (-5.31, 2.69); P=0.52], hospitalization expenses [standardized mean difference (SMD): 1.26, (-0.38, 2.89); P=0.13], and return to work between the anterior approach and posterior approach. However, the
posterior approach had the advantages of better Cobb angle correction [MD: 2.06, (0.17, 3.94); P=0.03], shorter operation time [MD: 58.29, (35.39, 81.18); P<0.00001], and lower estimated blood loss [MD: 185.92, (131.76, 240.07); P<0.00001].
UNASSIGNED: The
posterior approach appeared to be superior to the anterior approach in the treatment of TBFs. However, more high-quality randomized controlled trials should be conducted to confirm the conclusions of this study and guide clinical decision-making.