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成年脊柱形群体中脊柱骨固定缺陷:系统性审查和元分析
Kari Odland1, Hani Chanbour2, Scott L Zuckerman2
1Department of Orthopedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Suite R200, Minneapolis, MN, 55454, USA. kodland@umn.edu.
成年脊柱形手术后的脊柱骨固定缺陷 (SPFF) 在22.1%的病例中发生,最常见的原因是伪,杆骨折或螺丝松动. 为了获得一致的SPFF定义,需要进行进一步的研究.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科 整形外科 整形外科
- 生物机械工程 生物机械工程
背景情况:
- 脊柱骨固定缺陷 (SPFF) 是成年脊柱形手术 (ASD) 后的一个重要并发症,报告的发病率在4.5%至38.0%之间.
- 大约50%的SPFF病例需要重新手术,这突显了这种并发症的临床影响.
- 与其他ASD手术并发症相比,SPFF的预测因子和确切发病率的理解较少.
研究的目的:
- 系统地审查和分析现有的关于成年脊柱形 (ASD) 手术后脊柱形固定失败 (SPFF) 的文献.
- 确定SPFF的总体发生率,并确定最常见的故障机制.
- 提供SPFF的全面概述,以告知外科手术策略和患者护理.
主要方法:
- 在四个主要数据库 (Medline,SPORTDiscus,Cochrane图书馆,Scopus) 进行了系统的文献搜索.
- 纳入标准侧重于报告成人患者 (18岁以上) 进行ASD手术的SPFF率和失败类型的研究,这些患者接受了带有脊椎骨盆仪器的ASD手术,并进行了至少1年的随访.
- 提取的数据包括患者人口统计学,ASD类型和特定的故障模式 (例如,伪,杆断裂,螺丝松动).
主要成果:
- 包括3570名患者在内的14项研究符合纳入标准.
- 成年脊柱形手术后脊柱形固定失败 (SPFF) 的总比率为22.1%.
- 发现的最常见的故障机制是伪关节 (23.3%),杆骨折 (16.5%),上螺丝松动 (13.5%).
结论:
- 在ASD手术后,SPFF的总体发病率相当高,为22.1%.
- 伪骨,杆骨折和上螺丝松动是脊椎骨盆固定失败的主要方式.
- 在SPFF的研究定义中的异质性需要一种标准化的方法来改进报告,并指导患者特定固定结构的开发.
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