Efficacy and Safety of Posterior Long-Segment Fixation Versus Posterior Short-Segment Fixation for Kummell Disease: A Meta-Analysis,Geriatric Orthopaedic Surgery & Rehabilitation

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Efficacy and Safety of Posterior Long-Segment Fixation Versus Posterior Short-Segment Fixation for Kummell Disease: A Meta-Analysis
Geriatric Orthopaedic Surgery & Rehabilitation ( IF 1.6 ) Pub Date : 2022-06-13 , DOI: 10.1177/21514593221107509
Yikang Yu _{1,

2,

3} , Hanbing Zeng _{1,

4} , Enpin Guo _{1,

5} , Binbin Tang _{1,

4} , Yuan Fang _{1,

6} , Lianguo Wu ₄ , Chao Xu ₄ , Yi Peng ₁ , Bin Zhang ₁ , Zhen Liu ₁

Affiliation

Purpose

Posterior short-segment fixation (SSF) and long-segment fixation (LSF) are two methods for the treatment of Kummell disease, but the safety and effectiveness of these two surgical methods still lack adequate medical evidence. This study aimed to evaluate the two methods.

Methods

Database searches for randomized controlled trials, case-control studies, and cohort studies of posterior SSF and posterior LSF in the treatment of Kummell disease were performed. After the document quality was evaluated with the Newcastle-Ottawa Quality Assessment Scale, a meta-analysis was carried out.

Results

Meta-analysis revealed that the operation time and intraoperative blood loss in the LSF group were higher than those in the SSF group [MD = −18.17, 95% CI (−30.31, −6.03), z = 2.93, P = .003; MD = −82.07, 95% CI (−106.91, −57.24], z = 6.48, P < .00001). The postoperative last follow-up local kyphosis angle in the SSF group was greater than that in the LSF group (MD = 3.18, 95% CI [.56, 5.81], z = 2.38, P = .02), and there were no significant differences in perioperative complications, bone cement leakage rate, incidence of adverse events during follow-up, postoperative follow-up visual analog scale, postoperative Oswestry dysfunction index, and postoperative immediate local kyphosis angle between the two groups (P > .05).

Conclusion

SSF and LSF are effective and safe for the treatment of Kummell disease. SSF can reduce the operation time and intraoperative bleeding; LSF can better maintain the long-term stability of kyphosis. The methods should be evaluated by clinicians according to the individual situation of the patients.

中文翻译：

后路长节段固定与后路短节段固定治疗 Kummell 病的疗效和安全性：荟萃分析

目的

后路短节段固定（SSF）和长节段固定（LSF）是治疗Kummell病的两种方法，但这两种手术方法的安全性和有效性仍缺乏足够的医学证据。本研究旨在评估这两种方法。

方法

对后路 SSF 和后路 LSF 治疗 Kummell 病的随机对照试验、病例对照研究和队列研究进行了数据库搜索。在使用纽卡斯尔-渥太华质量评估量表评估文件质量后，进行了荟萃分析。

结果

Meta分析显示，LSF组的手术时间和术中出血量高于SSF组[MD = -18.17, 95% CI (-30.31, -6.03), z = 2.93, P = .003；MD = -82.07, 95% CI (-106.91, -57.24], z = 6.48, P < .00001)。SSF组术后末次随访局部后凸角大于LSF组（MD = 3.18, 95% CI [.56, 5.81], z = 2.38, P = .02），无两组围手术期并发症、骨水泥渗漏率、随访期间不良事件发生率、术后随访视觉模拟量表、术后Oswestry功能障碍指数、术后即刻局部后凸角差异有统计学意义（P >.05）。