Clinical efficacy and complications of short versus long segments of internal fixation for the treatment of degenerative scoliosis: A meta-analysis
10.3969/j.issn.2095-4344.2418
- Author:
Jian SUN
1
Author Information
1. Second Affiliated Hospital of Anhui Medical University
- Publication Type:Journal Article
- Keywords:
Cobb angle;
Coronal balance;
Degenerative scoliosis;
Internal fixation;
Long segment;
Meta-analysis;
Short segment;
The National Natural Science Foundation of China
- From:
Chinese Journal of Tissue Engineering Research
2020;24(3):438-445
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Currently, surgical methods for the treatment of degenerative scoliosis include simple decompression and decompression combined with internal fixation. However, there is still controversy over the choice of fixation and fusion segment in surgery, which requires more reliable evidence-based medical evidence for reference. OBJECTIVE: To evaluate the clinical efficacy and complication of short versus long segments of internal fixation for the treatment of degenerative scoliosis using meta-analysis. METHODS: CNKI, Wanfang Database, VIP, CBM, EMBase, PubMed, Web of Science, and Cochrane Library were searched to collect the randomized and non-randomized controlled studies which compared long fusion with short fusion in the treatment of degenerative scoliosis from inception to February 2019. Relevant conference papers and authoritative journals in the field were retrieved manually. The quality of the included studies was assessed by two evaluation members according to the Cochrane collaboration network standard or the Newcastle-Ottawa Scale. The included studies were analyzed by using RevMan 5.3 software. RESULTS AND CONCLUSION: (1) A total of 20 articles were included, involving a sample of 1 329 individuals. Long segment group consisted of 601 cases, and short segment group consisted of 728 cases. (2) The meta-analysis results showed that long-segment internal fixation surgery had better improvement of coronal Cobb angle (P=0.000 4), coronal balance (P=0.000 2), Oswestry disability index (P=0.003) and visual analogue scale score (P < 0.000 01). However, the incidence of implant failure (P=0.01) and dural tear (P=0.01) in short segment group was lower than that in long segment group. The short segment group had small trauma and shorter hospital stays after surgery (P < 0.000 1). (3) There was no statistical difference in other therapeutic indicators and complications between the two groups (P > 0.05). (4) These findings verify that long-segment internal fixation is superior to short-segment internal fixation in the correction of scoliosis, but the recovery is slow and the incidence of some complications after operation is high. It should be considered comprehensively when selecting specific surgical procedures.
