预测黄韧带骨化手术预后的因素:一项系统回顾和荟萃分析

IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY
Anish Tayal , Pragya Mitra , Aneeket Modak , Sucharu Asri , Kanwaljeet Garg
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引用次数: 0

摘要

本研究旨在确定胸椎黄韧带骨化(OLF)手术患者的人口统计学、临床表现、影像学表现和术中特征与术后预后之间的关系。方法检索spubmed、Ovid、Embase和Web of Sciences数据库,直到2023年7月,包括有关胸部黄韧带骨化手术预后因素的文章。使用预后质量研究(QUIPS)工具评估偏倚风险。通过计算手术恢复率(RR)来评估手术结果,RR =(术后日本骨科协会(JOA)评分-术前JOA评分)/(11 -术前JOA评分)。遵循流行病学观察性研究(MOOSE)的荟萃分析和系统评价和荟萃分析(PRISMA)指南的首选报告项目。此外,在开放和微创手术(MIS)亚组中分别评估与结果相关的因素。结果纳入36项研究,1511例患者。RR与年龄(p值= 0.012)、JOA评分(p值<; 0.001)、骨化区(胸椎中下段:p值= 0.042)、t2加权磁共振成像髓内信号强度变化(p值<; 0.001)、硬脑膜骨化的发生(p值= 0.006)相关。在亚组分析中,JOA评分(p值<; 0.001)和手术时间(p值= 0.014)与开放手术入路患者的预后相关,而与MIS技术患者的预后无关。结论虽然手术是治疗黄韧带骨化的基石,但考虑到上述因素,应仔细进行患者预后。此外,需要高质量的研究来证实本研究的发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors predicting the outcome of thoracic ossification of ligamentum flavum (OLF) surgery: A systematic review and meta-analysis

Background

The study aimed to determine the association between demographics, clinical presentation, radiological findings, and intraoperative characteristics of patients with thoracic ossification of ligamentum flavum (OLF) surgery and their postoperative outcomes.

Methods

PubMed, Ovid, Embase, and Web of Sciences databases were searched until July 2023 to include articles regarding the prognostic factors for thoracic OLF surgery. The risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool. The outcome of surgery was evaluated by calculating the recovery rate (RR), as follows: RR = (postoperative Japanese Orthopedic Association (JOA) score − preoperative JOA score)/(11 − preoperative JOA score). Meta-analyses Of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Furthermore, factors associated with outcome were assessed separately within open and minimally invasive surgery (MIS) subgroups.

Results

Thirty-six studies with 1,511 patients were included. RR was associated with age (p-value = 0.012), JOA score (p-value < 0.001), ossified region (middle vs. lower thoracic spine: p-value = 0.042), intramedullary signal intensity change on T2-weighted magnetic resonance imaging (p-value < 0.001), and occurrence of dural ossification (p-value = 0.006). On subgroup analysis, JOA score (p-value < 0.001) and operation time (p-value = 0.014) were associated with outcomes for patients managed with an open surgical approach, while none for those operated with the MIS technique.

Conclusion

Although surgery is the cornerstone of the management of OLF, careful patient prognostication should be performed considering the aforementioned factors. Further, high-quality research is warranted to confirm the findings of this study.
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来源期刊
Journal of Clinical Neuroscience
Journal of Clinical Neuroscience 医学-临床神经学
CiteScore
4.50
自引率
0.00%
发文量
402
审稿时长
40 days
期刊介绍: This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.
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