背景:成人脊柱畸形(ASD)是成人脊柱弯曲的畸形。ASD包括一系列导致患者生活质量下降以及使人衰弱的疾病的病理。治疗范围可以从非手术治疗到长段手术矫正,并且在很大程度上取决于畸形和患者情况。如果需要手术治疗,周向(前后联合入路)融合术是脊柱外科医生的医疗工具之一。根据复杂性,该程序在同一天完成或分阶段进行。决定是否以分阶段的方式进行环状手术很大程度上是基于外科医生的偏好和个体病例复杂性的感知;目前,没有高质量的证据可以用来支持这一决定。
目的:本文提出了一项系统评价方案,旨在研究ASD患者选择和预后方面同一天与分期圆周融合手术之间的差异。
方法:搜索将在MEDLINE上进行,Embase,Cochrane中央受控试验登记册,WebofScience,还有Scopus.灰色文献和全文筛选中包含的文章的参考列表也将被筛选纳入。结果将导出到Covidence。将收集人口统计数据,执行的程序类型,手术水平,失血,总操作时间,逗留时间,处置,再入院(30天和90天),围手术期并发症。还将评估患者报告的结果。随机对照试验的数据质量评估将使用CochraneCollaboration的工具来评估随机试验中的偏倚风险。非随机研究将使用ROBINS-I(非随机干预研究中的偏倚风险)工具进行评估。所有筛选,质量评估,数据提取将由2名独立审稿人完成。将进行描述性合成,和数据将被评估以进行进一步分析。
结果:本研究目前处于筛选阶段。还没有结果。搜索策略已经制定并记录在案。信息已导出到Covidence。关键评估阶段结束后,筛选和提取,以及结果的综合,将被执行。
结论:本综述将总结成人脊柱畸形同一天和分期(圆周)融合手术在围手术期结局和并发症方面的差异。它还将描述基于他们的人口统计学和病理学选择用于这样的程序的患者。确定的知识差距将提供对当前局限性的见解,并指导对这一主题的进一步研究。
背景:PROSPEROCRD42022339764;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=339764。
未经批准:PRR1-10.2196/42331。
BACKGROUND: Adult spinal deformity (ASD) is a deformity in the curvature of the adult spine. ASD includes a range of pathology that leads to decreased quality of life for patients as well as debilitating morbidities. Treatment can range from nonoperative management to long-segment surgical corrections and depends greatly on the deformity and patient profiles. If surgical treatment is indicated,
circumferential (a combined anterior and posterior approach) fusion is one of the tools in the spine surgeon\'s armamentarium. Depending on the complexity, the procedure is either completed on the same day or staged. Determining whether to perform a
circumferential surgery in a staged fashion is based largely on the surgeon\'s preference and perception of the individual case complexity; at present, there is no high-quality evidence that can be used to support that decision.
OBJECTIVE: This paper presents the protocol for a systematic review that aims to investigate the differences between same-day versus staged
circumferential fusion surgery in ASD both in patient selection and in outcomes.
METHODS: Searches will be performed on MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus. Gray literature and the reference lists of articles included in the full-text screening will also be screened for inclusion. Results will be exported to Covidence. Data will be collected on demographics, type of procedures performed, surgery levels, blood loss, total operation time, length of stay, disposition, readmissions (30 days and 90 days), and perioperative complications. Patient-reported outcomes will also be assessed. Data quality assessment of randomized controlled trials will be performed using the Cochrane Collaboration\'s tool for assessing risk of bias in randomized trials, and nonrandomized studies will be assessed with the ROBINS-I (Risk of Bias in Non-randomized Studies of Interventions) tool. All screening, quality assessment, and data extraction will be done by 2 independent reviewers. A descriptive synthesis will be performed, and data will be evaluated for further analysis.
RESULTS: This study is currently in the screening phase. There are no results yet. The search strategy has been developed and documented. Information has been exported to Covidence. Upon conclusion of the critical appraisal stage, screening and extraction, as well as a synthesis of the results, will be performed.
CONCLUSIONS: The intended review will summarize the differences in perioperative outcomes and complications between same-day and staged (
circumferential) fusion surgery in adult spinal deformity. It will also describe the patients selected for such procedures based on their demographics and pathology. Identified gaps in knowledge will provide insight into current limitations and guide further studies on this topic.
BACKGROUND: PROSPERO CRD42022339764; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=339764.
UNASSIGNED: PRR1-10.2196/42331.