Clinical outcome measures following lateral versus posterior sacroiliac joint fusion: Systematic review and meta-analysis

IF 1.9 Q3 CLINICAL NEUROLOGY
Khalid Medani , Abdulrhman Alsalama , Rakesh Kumar , Shlok Patel , Megh Patel , Sunil Manjila
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引用次数: 0

Abstract

Introduction

Sacroiliac joint fusion (SIJF) is indicated in patients with chronic Sacroiliac joint (SIJ) pain or instability and is usually performed using minimally invasive techniques through lateral or posterior approach.

Research question

Our study aims to compare the lateral approach to the posterior one in SIJF through meta-analysis of other studies. The outcome of each approach is measured using the visual analog scale (VAS), Oswestry disability index (ODI), or both.

Materials and methods

The study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Articles were extracted using Pubmed advance search till February 27th, 2023. Articles included were those limited to either lateral, posterior or both approaches. Articles written in a non-English language, case reports and smaller-than-three case series were excluded from the study. Risk of bias was assessed using the Newcastle-Ottawa and Jadad scales. Stata-17 software program was used for statistical analysis and creation of forest plots.

Results

Forty-eight articles were available for the quantitative analysis, which represents a total of 2562 subjects. The average duration of postoperative follow-up was 21 months (3–72 months) and 17 months (6–72 months) for the VAS and ODI outcomes, respectively. The average percentage of improvement in the VAS was 57% (22–80%) in the lateral approach versus 58% (29–94%) in the posterior approach (p = 0.986). The average percentage of improvement in the ODI was 42% (11–75%) in the lateral approach versus 31% (11–65%) in the posterior one (p = 0.272). A trend towards performing posterior approaches more frequently was noted in studies published after 2017.

Discussion and conclusion

Approach selection for SIJF depends mainly on patient's characteristics and surgeon's experience. Our study demonstrated no difference in VAS outcome between lateral and posterior approach. Lateral approach appeared to be superior in ODI outcome although not statistically significant. The main limitation of the study is the selection-bias as the majority of articles included were observational. Therefore, randomized procedural trials are needed to validate these findings.
骶髂外侧与后侧关节融合术后的临床结果测量:系统回顾和荟萃分析
骶髂关节融合术(SIJF)适用于慢性骶髂关节(SIJ)疼痛或不稳定的患者,通常采用微创技术通过外侧或后路入路进行。研究问题:本研究旨在通过对其他研究的meta分析,比较SIJF的侧入路与后路入路。使用视觉模拟量表(VAS)、Oswestry残疾指数(ODI)或两者同时测量每种方法的结果。材料和方法本研究遵循系统评价和荟萃分析(PRISMA) 2020指南的首选报告项目进行。文章提取使用Pubmed提前检索至2023年2月27日。纳入的文章局限于外侧入路、后入路或双入路。用非英语语言撰写的文章、病例报告和少于三个病例系列被排除在研究之外。使用Newcastle-Ottawa和Jadad量表评估偏倚风险。采用Stata-17软件进行统计分析和森林样地绘制。结果可定量分析的文献48篇,共2562名受试者。VAS和ODI的平均随访时间分别为21个月(3-72个月)和17个月(6-72个月)。侧入路VAS平均改善率为57%(22-80%),后路为58% (29-94%)(p = 0.986)。外侧入路ODI改善的平均百分比为42%(11-75%),后路为31% (11-65%)(p = 0.272)。在2017年之后发表的研究中,发现了更频繁地进行后验入路的趋势。结论SIJF的入路选择主要取决于患者的特点和外科医生的经验。我们的研究表明,侧路入路和后路入路的VAS结果没有差异。侧入路在ODI预后上似乎更优越,尽管没有统计学意义。该研究的主要局限性是选择偏倚,因为纳入的大多数文章都是观察性的。因此,需要随机程序试验来验证这些发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Brain & spine
Brain & spine Surgery
CiteScore
1.10
自引率
0.00%
发文量
0
审稿时长
71 days
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