摘要
目的:探讨腰椎后路融合术后cage后移的危险因素.方法:检索PubMed、Embase、Cochrane library、Web of Science、中国知网、万方数据库、中国生物医学文献服务系统自建库至2022年10月发表的有关腰椎后路融合术后cage后移的文献.采用RevMan5.2软件进行meta分析:计数资料采用比值比(OR),计量资料采用均数差值(MD).结果:共纳入14项研究,分析11 094例患者,评估12个危险因素.Meta分析结果显示,梨形椎间盘[OR=6.74,95％置信区间(95％CI):2.41～18.83,P=0.0003]、终板损伤(OR=8.27,95％CI:3.08～22.16,P＜0.001)、螺钉松动(OR=13.83,95％CI:5.66～33.78,P＜0.000 01)、单侧钉棒系统固定(OR=4.20,95％CI:1.72～10.26,P=0.002)与腰椎后路融合术后 cage 后移有关;性别(OR=0.61,95％CI:0.29～1.27,P=0.19)、术前诊断(OR=1.04,95％CI:0.70～1.57,P=0.84)、手术节段(OR=0.94,95％CI:0.73～1.20,P=0.61)、多节段融合(OR=1.03,95％CI:0.73～1.46,P=0.86)、体重指数(MD=0.14,95％CI:-0.81～2.01,P=0.78)与腰椎后路融合术后cage后移无关.结论:梨形椎间盘、终板损伤、螺钉松动、单侧钉棒系统固定为腰椎后路融合术后cage后移的危险因素.
Abstract
Objective:To investigate the risk factors for cage retropulsion after lumbar interbody fusion.Methods:Literatures on cage retropulsion after lumbar interbody fusion were retrieved from PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang database,China Biomedical Literature Service System and other databases with time range from establishment of databases to October 2022.RevMan 5.2 software was used for meta-analysis.Odds ratio(OR)was used for count data,and mean difference(MD)was used for continuous data.Results:Totally 11 094 patients from 14 studies were collected and 12 risk factors were included.The results of the meta analysis showed that pear-shaped disc(OR=6.74,95％confidence interval[95％CI]:2.41-18.83,P=0.000 3),endplate injury(OR=8.27,95％CI:3.08-22.16,P＜0.001),screw loosening(OR=13.83,95％CI:5.66-33.78,P＜0.000 01)or unilateral screw-rod fixation(OR=4.20,95％CI:1.72-10.26,P=0.002)were the risk factors for cage retropulsion.Sex(OR=0.61,95％CI:0.29-1.27,P=0.19),preoperative diagnosis(OR=1.04,95％CI:0.70-1.57,P=0.84),surgical segments(OR=0.94,95％CI:0.73-1.20,P=0.61),multilevel fusion(OR=1.03,95％CI:0.73-1.46,P=0.86),body mass index(MD=0.14,95％CI:-0.81-2.01,P=0.78)were not risk factors for cage retropulsion.Conclusions:According to current evidence,pear-shaped disc,endplate injury,screw loosening and unilateral pedicle screw fixation are significant risk factors for cage retropulsion.
维普
万方数据