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C2与C3或C4作为长段子宫融合的上部仪器脊椎:系统性审查和元分析
Esteban Quiceno1, Amna Hussein1, Annie Pico1
11Department of Neurosurgery, University of Arizona College of Medicine, Phoenix, Arizona; and.
Journal of neurosurgery. Spine
|December 1, 2023
概括
与C3 / C4相比,在C2定长宫融合可能会降低近端相邻段疾病 (ASD) 的重新操作率. 这一系统性审查发现这两个定级别之间的整体并发症率相似.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 脊柱融合技术 脊柱融合技术
背景情况:
- 对于长度的宫融合来说,选择正面位 (C2 vs. C3/C4) 是一个临床挑战.
- 关于长子宫结构中的近位衰竭的数据有限.
- 靠近相邻细分体疾病 (ASD) 是长细分体融合的一个问题.
研究的目的:
- 系统地审查和元分析近端ASD在长宫和宫胸融合中的发生率.
- 为了比较 C2 和 C3/C4.4 上部仪器脊椎 (UIV) 的结构之间的结果.
主要方法:
- 在PubMed,Embase和Cochrane Central的系统文献搜索中遵循了PRISMA的指导方针.
- 纳入标准:≥3级后宫融合,UIV在C2与C3/C4之间,退行性磁盘疾病,宫脊髓炎或宫变形.
- 分析使用基于I2值的固定效应或随机效应模型;使用漏斗图表评估了出版偏差.
主要成果:
- 分析了7项涉及1215名患者的研究 (403名在C2 UIV组,812名在C3/C4 UIV组).
- 总体上,重新运行率相似 (C2的9.2%,C3/C4的9.4%,p=0.93).
- 由于近位病理的外科ASD在C2UIV组显着较低 (1.2%对3%,或0.36,p=0.02).
结论:
- 在C2的长段宫/宫胸部结构可能为近端ASD提供较低的修订率,而不是在亚轴脊柱的结构.
- 在C2和C3/C4UIV组之间,并发症率是可比的.
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