Comparison of surgery and conservative treatment for senile dens fractures of Anderson-D Alonzo type Ⅱ or Ⅲ: a Meta-analysis
10.3760/cma.j.issn.1671-7600.2017.03.008
- VernacularTitle:老年Anderson-D AlonzoⅡ型或Ⅲ型齿状突骨折手术治疗和保守治疗比较的Meta分析
- Author:
Huajun LING
;
Lei FAN
;
Jianwen DONG
;
Weiwen LIN
;
Qiyou WANG
- Keywords:
Cervical vertebrae;
Fractures,bone;
Surgical procedures,operative;
Conservative treatment;
Meta-analysis
- From:
Chinese Journal of Orthopaedic Trauma
2017;19(3):225-233
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the operative and conservative treatments for senile dens fractures of Anderson-D Alonzo type Ⅱ or Ⅲ using Meta-analysis.Methods A literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,Wanfang Data and CNKI for studies on senile dens fractures of Anderson-D Alonzo type Ⅱ or Ⅲ from the earliest records through June 2016.The relative studies identified were screened by 2 independent authors.The quality of these articles was evaluated using modified Newcastle-Ottawa scale,and the meta-analysis was conducted using Review Manager 5.3.Results A total of 22 articles were brought into this Meta-analysis.The union rate was significantly higher in the operative group than in the conservative group[OR =0.30,95％ CI(0.20,0.44),P ＜ 0.001];the mortality in the operative group was significantly lower than in the conservative group[OR =0.61,95％ CI (0.39,0.96),P=0.03];the complication rate was similar in both groups[OR=1.09,95％ CI(0.76,1.57),P ＜ 0.46].The heterogeneity of all the 3 indexes was low.In the subgroup analysis,the union rate was significantly higher in posterior operations than in anterior operations or conservative treatments (P ＜ 0.05).Conclusion For the elderly patients with dens fracture of type Ⅱ or Ⅲ who can tolerate surgery,operative treatment may be more suitable because it can lead to much better prognosis.
