Comparison of minimally invasive percutaneous and conventional open pedicle screw fixation for thoracolumbar fractures：a meta-analysis
10.3969/j.issn.2095-4344.2016.13.019
- VernacularTitle:微创经皮与传统开放椎弓根螺钉置入固定胸腰椎骨折的文献荟萃
- Author:
Wen XUE
;
Shurao LIU
;
Xiaoli GUAN
;
Zengping WANG
;
Zhongren KANG
;
Huiru ZHOU
;
Lin LIU
;
Raowen QIAN
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2016;20(13):1961-1969
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Open reduction pedicle screw fixation for thoracolumbar fracture could obtain satisfactory effects, and has been extensively used. However, it has potential risk during and after repair. Minimaly invasive percutaneous pedicle screw technique minimizes the trauma and complications of soft tissue. It remains poorly understood which is better minimaly invasive percutaneous or conventional open pedicle screw fixation for the repair of thoracolumbar fracture. OBJECTIVE:To perform quality evaluation and meta-analysis on curative effect and postoperative complications of minimaly invasive percutaneous and conventional open pedicle screw fixation in the treatment of thoracolumbar fractures. METHODS:A detailed search of several electronic databases, including Cochrane Library, PubMed, WanFang, CNKI, VIP and CBM, was undertaken. Simultaneously,Chinese Journal of Orthopaedics, Chinese Journal of Orthopaedic Trauma, and Chinese Journal of Trauma were checked by hand to identify controled trials regarding minimaly invasive percutaneous and conventional open pedicle screw fixation in the treatment of thoracolumbar fractures published from inception to 2015, and the references of the included studies were checked. According to inclusion and exclusion criteria, references were screened, data were extracted and quality was evaluated by four investigators independently. Meta-analysis was conducted using RevMan 5.2 software. The quality of references of the included controled trials was assessed with CONSORT statement and some surgery clinical evaluation indexes. RESULTS AND CONCLUSION: We included 28 studies, including 25 randomized controled trials/quasi-randomized controled trials and 3 retrospective comparative studies, with 1 285 patients. Meta-analysis results demonstrated that compared with the conventional open pedicle screw, minimaly invasive percutaneous pedicle screw fixation could significantly reduce operation time, blood loss, hospital stays, postoperative complication rate and height loss (P < 0.05). No significant difference in postoperative pain grade was detected between them (P > 0.05). These results indicate that minimaly invasive percutaneous pedicle screw fixation for thoracolumbar fracture was safe and reliable, had smal trauma, less blood loss, rapid recovery, short hospital stay, and less postoperative complications. Nevertheless, methods and results of most studies are not detailed enough. We suggested reporting randomized controled trials according to related standards in order to improve the report quality and authenticity of randomized controled trials.
