Predicting Surgical and Non-surgical Curvature Correction by Radiographic Spinal Flexibility Assessments for Patients With Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis.
Yu-Yan Luo, Tim-Mei Hung, Qian Zheng, Hui-Dong Wu, Man-Sang Wong, Zi-Qian Bai, Christina Zong-Hao Ma
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引用次数: 0
Abstract
Study DesignSystematic Review and Meta-analysis.ObjectivesThis systematic review and meta-analysis aimed to: (1) synthesize the prevalent application ratios of 2 radiographic spinal flexibility assessment methods in AIS patients treated with PSF or bracing; and (2) quantitatively evaluate the accuracy of these methods in predicting post-intervention correction outcomes.MethodsA systematic search was conducted across 5 electronic databases: CINAHL, Embase, Ovid, PubMed, and Web of Science. Meta-analyses were performed to investigate the accuracy of the spinal flexibility rate in predicting the post-intervention correction rate in AIS patients treated with PSF surgery or bracing, using RevMan 5.4.1 software.ResultsThe results of 31 studies, involving 1868 AIS patients, showed that the side-bending method was utilized more frequently than the fulcrum-bending method in both treatments. Meanwhile, the spinal flexibility evaluated by the fulcrum-bending method may provide a more accurate prediction of post-surgical correction compared to the side-bending approach, particularly for main curves. For the bracing treatment, only a few studies have preliminarily reported good capability of the side-bending method in predicting the initial in-brace correction.ConclusionsThis review quantitatively assessed the clinical application ratio and effectiveness of side-bending and fulcrum-bending radiographs in predicting post-intervention curve corrections in AIS patients undergoing surgical or bracing treatments. The results of the current review supported to adopt the fulcrum-bending approach for AIS patients undergoing PSF surgery with main thoracic curves, and the side-bending approach for those with thoracolumbar/lumbar curves. For patients receiving bracing treatment, further research is still needed to confirm the clinical value of the side-bending method.
研究设计:系统评价和荟萃分析。目的:本系统综述和荟萃分析旨在:(1)综合两种影像学脊柱柔韧性评估方法在接受PSF或支具治疗的AIS患者中的普遍应用比例;(2)定量评价这些方法预测干预后矫正结果的准确性。方法:系统检索5个电子数据库:CINAHL、Embase、Ovid、PubMed和Web of Science。采用RevMan 5.4.1软件进行meta分析,探讨脊柱柔韧性率预测经PSF手术或支具治疗的AIS患者干预后矫治率的准确性。结果:涉及1868例AIS患者的31项研究结果显示,侧弯法在两种治疗中均比支点弯曲法使用频率更高。同时,与侧弯入路相比,用支点弯曲法评估脊柱柔韧性可以提供更准确的术后矫正预测,特别是对于主要弯曲。对于支具治疗,只有少数研究初步报道了侧弯法预测支具内初始矫正的良好能力。结论:本综述定量评估了侧弯和支点弯曲x线片在预测接受手术或支具治疗的AIS患者干预后曲线矫正方面的临床应用比例和有效性。本综述的结果支持采用支点弯曲入路治疗胸椎主弯的AIS患者,采用侧弯入路治疗胸腰椎/腰椎弯的AIS患者。对于接受支具治疗的患者,侧弯法的临床应用价值还有待进一步研究。
期刊介绍:
Global Spine Journal (GSJ) is the official scientific publication of AOSpine. A peer-reviewed, open access journal, devoted to the study and treatment of spinal disorders, including diagnosis, operative and non-operative treatment options, surgical techniques, and emerging research and clinical developments.GSJ is indexed in PubMedCentral, SCOPUS, and Emerging Sources Citation Index (ESCI).