Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (27): 4398-4405.doi: 10.3969/j.issn.2095-4344.2797
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Xiang Xi1, Si Qunchao1, Cheng Weiyi2, Cao Ping1, Zheng Jinpeng1, Hu Bing1
Received:
2019-12-24
Revised:
2019-12-27
Accepted:
2020-01-22
Online:
2020-09-28
Published:
2020-09-10
Contact:
Hu Bing, Chief physician, Associate professor, Department of Orthopedics, Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430000, Hubei Province, China
About author:
Xiang Xi, Master candidate, Department of Orthopedics, Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430000, Hubei Province, China
CLC Number:
Xiang Xi, Si Qunchao, Cheng Weiyi, Cao Ping, Zheng Jinpeng, Hu Bing. A network meta-analysis of different surgical methods in the treatment of lumbar disc herniation[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(27): 4398-4405.
2.3.2 腰痛目测类比评分 纳入的42个研究中有23个报告了患者术后腰痛的随访目测类比评分[4-5,10,15-17,19-23,29-30,32,35,38-45]。纳入患者2 719例,其中腰椎间盘置换术297例、椎间盘融合术612例、标准椎间盘切除术552例、椎间盘镜下髓核摘除术426例、显微镜下髓核摘除术291例、经皮内窥镜腰椎间盘切除术178例及经皮激光椎间盘减压术148例。各手术方式结果比较差异无显著性意义,见表3,其中标准椎间盘切除术vs.椎间盘融合术比较差异有显著性意义,缓解腰痛疗效排序为腰椎间盘置换术>腰椎间盘融合术>椎间盘镜下髓核摘除术>经皮内窥镜腰椎间盘切除术>显微镜下髓核摘除术>经皮激光椎间盘减压术>标准椎间盘切除术。 "
2.3.4 手术成功率 纳入的42个研究中有28个报告了患者术后随访的手术成功率[4-5,7-13,17-18,20,22,24-37,42]。纳入患者3 259例,其中腰椎间盘置换术940例、椎间盘融合术480例、标准椎间盘切除术703例、椎间盘镜下髓核摘除术218例、显微镜下髓核摘除术233例、经皮内窥镜腰椎间盘切除术178例、经皮激光椎间盘减压术48例、化学溶核术359例及自动经皮腰椎间盘切除术100例。各手术方式结果比较部分差异有显著性意义,见表5,手术成功率方面排序为腰椎间盘置换术>腰椎间盘融合术>椎间盘镜下髓核摘除术>经皮内窥镜腰椎间盘切除术>标准椎间盘切除术>经皮激光椎间盘减压术>显微镜下髓核摘除术>化学溶核术>自动经皮腰椎间盘切除术。 "
2.3.5 再手术率 纳入的42个研究中有29个报告了患者术后随访的再手术率[5-12,14-16,18-23,25-28,30,32-33,36-37,41,45]。纳入患者4 461例,其中腰椎间盘置换术1 062例、椎间盘融合术801例、标准椎间盘切除术1 080例、椎间盘镜下髓核摘除术357例、显微镜下髓核摘除术381例、经皮内窥镜腰椎间盘切除术170例、经皮激光椎间盘减压术148例、化学溶核术362例及自动经皮腰椎间盘切除术100例。各手术方式结果比较差异无显著性意义,见表6,再次手术率方面排序为腰椎间盘置换术>腰椎间盘融合术>显微镜下髓核摘除术>椎间盘镜下髓核摘除术>标准椎间盘切除术>经皮内窥镜腰椎间盘切除术>经皮激光椎间盘减压术>化学溶核术>自动经皮腰椎间盘切除术。 "
2.3.6 并发症发生率 纳入的42个研究中有29个报告了术后随访的并发症发生率[5,7-10,12-19,21-22,25-26,29-33,35-38,41,44-45]。纳入患者4 153例,其中腰椎间盘置换术901例、椎间盘融合术762例、标准椎间盘切除术1 122例、椎间盘镜下髓核摘除术354例、显微镜下髓核摘除术260例、经皮内窥镜腰椎间盘切除术248例、经皮激光椎间盘减压术100例、化学溶核术337例及自动经皮腰椎间盘切除术69例。各手术方式结果比较部分差异有显著性意义,见表7,并发症发生率方面排序为经皮内窥镜腰椎间盘切除术>自动经皮腰椎间盘切除术>标准椎间盘切除术>显微镜下髓核摘除术>经皮激光椎间盘减压术>椎间盘镜下髓核摘除术>腰椎间盘置换术>腰椎间盘融合术>化学溶核术。 "
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