Meta analysis of cortical bone trajectory screw and pedicle screw in posterior thoracic and lumbar fusion

doi:10.3969/j.issn.1006-7795.2019.04.004

Abstract

Abstract: Objective To evaluate the application of cortical bone trajectory screw (CBT) and traditional pedicle screw (PS) in posterior thoracic and lumbar surgery with Meta analysis. Methods A comparative study of all CBT and PS before February 2019 was searched with Pubmed and Wanfang data. Inclusion criteria:1Comparative study of CBT and PS in posterior thoracic and lumbar fusion;2All of them were operated by hand and did not involve special navigation system;3Posterior open surgery. Exclusion criteria:1Combined anterior and posterior surgery;2A special navigation system was used;3A percutaneous nailing technique was used. The data were extracted and sorted with Excel software and Revman 5.3.5 was used for data analysis. The subjects included fusion, intraoperative estimated blood loss, volume, operation time, hospitalization time, postoperative complications, and Oswestry Disability Index (ODI) score. Results A total of 13 literatures including 12 English and 1 Chinese literatures were included in this study, with 2 randomized controlled trial (RCT) and the rest cohort studies. The total number of people included was 855. ①Last fusion:there was no good reason to believe that there was a difference in integration. ②The amount of intraoperative blood loss:the intraoperative bleeding of CBT was lower than that of PS, with significant difference. ③Operation time:in posterior open surgery, the operation time of CBT was significantly lower than that of PS, with statistically significant difference. ④Hospital stay:compared with PS surgery group, hospitalization time after CBT operation was shorter, with statistically significant difference. ⑤Concurrent development syndrome:the overall incidence of complications of CBT surgery was lower than that of PS, with statistical significance. However, there was no good reason to support the difference in the incidence of intraoperative dural leakage between the two groups. ⑥The ODI score of the last follow-up:there was no good reason to support the difference between CBT and PS in the last ODI score after operation. Conclusion The results of this study show that CBT is superior to PS in evaluating blood loss, complications, operation time and hospitalization time during operation, but in dural injury and fusion rate, there was no sufficient reason to confirm the difference in ODI score after the last follow-up.

Key words: cortical bone trajectory screw, pedicle screw, vertebral fusion

CLC Number:

R681.5⁺3

Zhang Tianqing, Zhang Xino, Han Bo, Li Yue, Pan Aixing, Liu Tie, Hai Yong, Guan Li, Liu Yuzeng. Meta analysis of cortical bone trajectory screw and pedicle screw in posterior thoracic and lumbar fusion[J]. Journal of Capital Medical University, 2019, 40(4): 510-516.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2019.04.004

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2019/V40/I4/510

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