磷酸钙陶瓷与自体骨移植在脊柱融合术中融合效果的Meta分析

The spinal fusion results between calcium phosphate ceramics and autologous iliac, a meta-analysis

中文关键词:  脊柱融合术  磷酸钙  自体骨移植  Meta分析

英文关键词:Spinal fusion  Calcium phosphates  Autograft  Meta-analysis

中文摘要:

  【摘要】 目的：系统评价磷酸钙陶瓷与自体骨移植在脊柱融合术中融合效果的差异。方法：计算机检索1990年1月～2012年10月Pubmed、Embase、ScienceDirect、OVID、Springer Link，Wiley Online Library、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）和万方数据库，收集关于磷酸钙陶瓷与自体骨移植应用于脊柱融合术的随机对照研究（randomized controlled trial，RCT）并评价纳入研究的方法学质量，利用STATA 12.0软件进行统计分析。结果：共有8篇研究符合标准，共计388例患者被纳入分析。其中7篇研究报告了两种融合材料的具体例数，共357例，磷酸钙陶瓷组178例，自体骨移植组179例，两组按例数计算的融合率之间的差异无统计学意义[RR=0.975，95%CI（0.887，1.073）；RD=-0.009，95%CI（-0.048，0.031）]。6篇研究报告了两种融合材料的具体融合节段，其中磷酸钙陶瓷组为217节，自体骨移植组为205节，两组按融合节段计算的融合率之间的差异无统计学意义[RR=0.979，95%CI（0.903，1.061）；RD=-0.009，95%CI（-0.043，0.026）]。结论：磷酸钙陶瓷与自体骨移植应用于脊柱融合术均可达到满意的融合效果，磷酸钙陶瓷可作为自体骨的替代和补充材料。

英文摘要:

  【Abstract】 Objectives: To evaluate the efficacy of calcium phosphate ceramics versus autograft on spinal fusion. Methods: Randomized controlled trials related to application of calcium phosphate ceramics in spinal fusion versus autograft were searched on Pubmed, Embase, ScienceDirect, OVID, Springer Link, Wiley Online Library, Chinese biomedical database(CBM), Chinese National Knowledge Infrastructure(CNKI) and Wan fang database from January 1990 to October 2012. Some relevant journals were hand-searched as well． Two reviewers independently evaluated the quality of the included studies and extracted the data. Meta-analysis was performed by STATA 12.0 software. Results: Eight randomized controlled trials involving 388 patients were included. The exact number of participants was reported in seven trials, including a total of 357 patients. 178 patients underwent allograft with calcium phosphate ceramics, and 179 patients with autograft. The combined results showed no statistically significant difference in the fusion rate between the two groups[RR=0.975, 95%CI(0.887, 1.073); RD=-0.009, 95%CI(-0.048, 0.031)]. Six eligible studies recorded the number of fused levels, that 217 levels underwent allograft with calcium phosphate ceramics and 205 levels with autograft. No significant difference was identified between the two groups[RR=0.979, 95%CI(0.903, 1.061); RD=-0.009, 95%CI(-0.043, 0.026)]. Conclusion: Both calcium phosphate ceramics and autograft are effective for spinal fusion. Calcium phosphate ceramics is a favorable alternative to autograft.