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腰部退行性疾病的单一层次与多层次的腰部体融合:系统性审查和元分析

Dana Ibrahim Alharbi¹, Waleed Osama Samarkandi², Leen Saleh Albraik¹

¹College of Medicine, Alfaisal University, 11533, Riyadh, Saudi Arabia.

Journal of orthopaedic surgery and research

|March 15, 2026

概括

单层腰部融合显示出比多层融合更好的术后结果,修订率更低,并发症更少. 然而,证据的确定性很低,需要对个体患者的需求进行谨慎的解释.

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:

退行性脊髓缩病影响全球数百万人,为单级疾病建立了融合协议.
针对多级退行性脊髓缩症的最佳手术策略仍在争论中,缺乏对结果进行比较的数据.
这项研究解决了证据的稀缺性,比较单级与多级体际融合对于这种情况.

研究的目的:

为了研究腰部内体融合程度对患者结局的影响.
为了比较单层融合与退行性脊髓溶解中的双层或多层融合.
根据化水平的数量来评估术后和并发症率.

主要方法:

10项研究的系统综述和元分析 (N=1430名患者).
在主要数据库 (PubMed,Scopus,Web of Science,Cochrane) 进行的搜索.
使用R软件分析结果,通过GRADE评估证据的确定性.

主要成果:

单层融合与41%较低的修订率 (p=0.007) 和84%较少的螺丝松动 (p<0.001) 相关.
在单级手术中,手术时间 (-60.73分钟),血液损失 (-286.99毫升) 和住院时间 (-1.22天) 显著减少.
在感染率或重大并发症方面没有观察到显著差异;在外科手术期间的结果中注意到高度异质性.

结论:

与多层结构相比,单层腰部融合显示出潜在的优越的外科外围形状.
虽然修订风险和硬件并发症较低,但整体并发症率没有显著差异.
结果需要谨慎解释,因为证据的确定性低至非常低,并且存在大量的异质性,强调个性化治疗决策.

关键词:

一个LIF就是一个LIF.腰部融合腰部融合腰部融合单一水平单一水平单一水平脊髓溶解体的发生.

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