Abdul Hafid Bajamal, Eko Agus Subagio, Pandu Wicaksono, I Gusti Made Aswin Rahmadi Ranuh, Muhammad Faris, Budi Utomo
{"title":"颈椎轴下损伤手术:前路、后路还是前后联合路?","authors":"Abdul Hafid Bajamal, Eko Agus Subagio, Pandu Wicaksono, I Gusti Made Aswin Rahmadi Ranuh, Muhammad Faris, Budi Utomo","doi":"10.31616/asj.2023.0266","DOIUrl":null,"url":null,"abstract":"<p><p>Both anterior and posterior approaches have shown insignificant differences in good clinical outcomes with one over another advantages and disadvantages. This review aimed to provide evidence for the best management of subaxial cervical spine injuries and discuss the clinical outcomes and complications. Clinical studies of anterior versus posterior and anterior versus anterior-posterior (combined) approaches to subaxial cervical spine injury were searched electronically from PubMed, Medline, ScienceDirect, Cochrane Library, and other Internet databases. Clinical improvement, complication rates, and mortality rates showed no significant differences with an odds ratio of 1.09 (95% confidence interval [CI], 0.79-1.49; p=0.61) for the anterior versus posterior approach and an odds ratio of 1.05 (95% CI, 0.35-3.18; p=0.93) for the anterior versus the combined approach. Surgical duration and blood loss were significantly different between the anterior and posterior groups with a mean difference of -42.84 (95% CI, -64.39 to 21.29; p<0.0001); -212.91 (95% CI, -417.60 to 8.22; p=0.04), respectively, whereas the length of hospitalization did not (p=0.16). No difference was found between the groups when compared by clinical improvement and complication rate. Meanwhile, the anterior approach was superior to the posterior approach in terms of surgical duration, blood loss, and hospitalization length.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366557/pdf/","citationCount":"0","resultStr":"{\"title\":\"Surgery for subaxial cervical spine injuries: which is better: anterior, posterior, or anterior-posterior combined approach?: a systematic review and meta-analysis.\",\"authors\":\"Abdul Hafid Bajamal, Eko Agus Subagio, Pandu Wicaksono, I Gusti Made Aswin Rahmadi Ranuh, Muhammad Faris, Budi Utomo\",\"doi\":\"10.31616/asj.2023.0266\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Both anterior and posterior approaches have shown insignificant differences in good clinical outcomes with one over another advantages and disadvantages. This review aimed to provide evidence for the best management of subaxial cervical spine injuries and discuss the clinical outcomes and complications. Clinical studies of anterior versus posterior and anterior versus anterior-posterior (combined) approaches to subaxial cervical spine injury were searched electronically from PubMed, Medline, ScienceDirect, Cochrane Library, and other Internet databases. Clinical improvement, complication rates, and mortality rates showed no significant differences with an odds ratio of 1.09 (95% confidence interval [CI], 0.79-1.49; p=0.61) for the anterior versus posterior approach and an odds ratio of 1.05 (95% CI, 0.35-3.18; p=0.93) for the anterior versus the combined approach. Surgical duration and blood loss were significantly different between the anterior and posterior groups with a mean difference of -42.84 (95% CI, -64.39 to 21.29; p<0.0001); -212.91 (95% CI, -417.60 to 8.22; p=0.04), respectively, whereas the length of hospitalization did not (p=0.16). No difference was found between the groups when compared by clinical improvement and complication rate. Meanwhile, the anterior approach was superior to the posterior approach in terms of surgical duration, blood loss, and hospitalization length.</p>\",\"PeriodicalId\":8555,\"journal\":{\"name\":\"Asian Spine Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366557/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian Spine Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.31616/asj.2023.0266\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Spine Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31616/asj.2023.0266","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/21 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
前路和后路两种方法在良好的临床效果方面差异不大,各有利弊。本综述旨在为颈椎轴下损伤的最佳治疗方法提供证据,并讨论临床疗效和并发症。通过电子方式从PubMed、Medline、ScienceDirect、Cochrane图书馆和其他互联网数据库中检索了关于颈椎轴下损伤的前路与后路、前路与前后路(联合)方法的临床研究。临床改善、并发症发生率和死亡率无显著差异,前路与后路方法的几率比为1.09(95% 置信区间[CI],0.79-1.49;P=0.61),前路与联合方法的几率比为1.05(95% CI,0.35-3.18;P=0.93)。手术时间和失血量在前路组和后路组之间有显著差异,平均差异为 -42.84 (95% CI, -64.39 to 21.29; p)。
Surgery for subaxial cervical spine injuries: which is better: anterior, posterior, or anterior-posterior combined approach?: a systematic review and meta-analysis.
Both anterior and posterior approaches have shown insignificant differences in good clinical outcomes with one over another advantages and disadvantages. This review aimed to provide evidence for the best management of subaxial cervical spine injuries and discuss the clinical outcomes and complications. Clinical studies of anterior versus posterior and anterior versus anterior-posterior (combined) approaches to subaxial cervical spine injury were searched electronically from PubMed, Medline, ScienceDirect, Cochrane Library, and other Internet databases. Clinical improvement, complication rates, and mortality rates showed no significant differences with an odds ratio of 1.09 (95% confidence interval [CI], 0.79-1.49; p=0.61) for the anterior versus posterior approach and an odds ratio of 1.05 (95% CI, 0.35-3.18; p=0.93) for the anterior versus the combined approach. Surgical duration and blood loss were significantly different between the anterior and posterior groups with a mean difference of -42.84 (95% CI, -64.39 to 21.29; p<0.0001); -212.91 (95% CI, -417.60 to 8.22; p=0.04), respectively, whereas the length of hospitalization did not (p=0.16). No difference was found between the groups when compared by clinical improvement and complication rate. Meanwhile, the anterior approach was superior to the posterior approach in terms of surgical duration, blood loss, and hospitalization length.