儿科或青少年患者椎间盘切除术的证据仍然很少,这项单臂荟萃分析调查了该人群中腰椎间盘突出症(LDH)的椎间盘切除术。PubMed,Embase(Elsevier),CiNAHL,科克伦图书馆,Scopus,搜索了WebofScience。合格的研究报告了21岁以下诊断为LDH的儿科患者,并通过椎间盘切除术进行了手术治疗。这篇评论在PROSPERO注册(ID:CRD42023463358)。22项研究符合资格标准(n=1182)。基线时背痛的视觉模拟评分(VAS)评分为5.34(95%CI:4.48,6.20,I2=98.9%)。术后12个月VAS背痛评分为0.88分(95%CI:0.57,1.19,I2=95.6%)。基线时腿部疼痛的VAS评分为7.03(95%CI:6.63,7.43,I2=93.5%)。术后12个月VAS腿部疼痛评分为1.02(95%CI:0.68,1.36,I2=97.0%)。基线时Oswestry残疾指数(ODI)评分为55.46(95%CI:43.69,67.24,I2=99.9%)。术后12个月ODI评分为7.82(95%CI:4.95,10.69,I2=99.4%)。VAS返回,VAS腿和ODI评分在所有术后点都显示出最小的临床重要差异(MCID)。围手术期结果显示手术时间为85.71分钟(95%CI:73.96,97.46,I2=99.4%),住院时间为3.81天(95%CI:3.20,4.41,I2=98.5%)。术后再手术率为0.01(95%CI:<0.00,0.02,I2=0%)。椎间盘切除术在患有LDH的儿科和青少年患者中安全有效。这里的研究结果为未来针对保守措施的随机对照试验提供了基础,以阐述最佳管理并阐明长期结果。
Corroborative evidence for discectomy in pediatric or adolescent patients remains scarce, with this single-arm meta-analysis investigating discectomy for lumbar disc
herniation (LDH) within this population. PubMed, Embase (Elsevier), CiNAHL, Cochrane Library, Scopus, and Web of Science were searched. Eligible studies reported pediatric patients under 21 years of age with a diagnosis of LDH that was treated surgically with discectomy. This review was registered in PROSPERO (ID: CRD42023463358). Twenty-two studies met the eligibility criteria (n=1182). Visual analog scale (VAS) scores for back pain at baseline were 5.34 (95% CI: 4.48, 6.20, I2=98.9%). Postoperative VAS back pain scores after 12 months were 0.88 (95% CI: 0.57, 1.19, I2=95.6%). VAS scores for leg pain at baseline were 7.03 (95% CI: 6.63, 7.43, I2=93.5%). Postoperative VAS leg pain scores after 12 months were 1.02 (95% CI: 0.68, 1.36, I2=97.0%). Oswestry disability index (ODI) scores at baseline were 55.46 (95% CI: 43.69, 67.24, I2=99.9%). Postoperative ODI scores after 12 months were 7.82 (95% CI: 4.95, 10.69, I2=99.4%). VAS back, VAS leg and ODI scores demonstrated a minimum clinically important difference (MCID) at all postoperative points. Perioperative outcomes demonstrated operative time as 85.71 mins (95% CI: 73.96, 97.46, I2=99.4%) and hospital length of stay as 3.81 days (95% CI: 3.20, 4.41, I2=98.5%). The postoperative reoperation rate at the same level was 0.01 (95% CI: <0.00, 0.02, I2=0%). Discectomy appears safe and effective in pediatric and adolescent patients suffering from LDH. The findings here provide groundwork for future randomized control trials against conservative measures to elaborate on optimal management and elucidate long-term outcomes.