Effectiveness and safety of surgical interventions for treating adolescent idiopathic scoliosis: a Bayesian meta-analysis

被引:15
作者
Chen, Long [1 ]
Sun, Zeyu [1 ]
He, Jingming [1 ]
Xu, Yunwen [2 ]
Li, Zhuhai [3 ]
Zou, Qian [1 ]
Li, Bo [1 ]
机构
[1] Guizhou Prov Peoples Hosp, Dept Orthoped, 83 Zhongshan East Rd, Guiyang 550000, Guizhou, Peoples R China
[2] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA
[3] Peoples Hosp Guangxi Zhuang Autonomous Reg, Dept Orthoped, Nanning 530021, Guangxi, Peoples R China
基金
中国国家自然科学基金;
关键词
Adolescent idiopathic scoliosis; Surgical interventions; Pulmonary function; Complications; Cobb angle; Bayesian meta-analysis; POSTERIOR SPINAL-FUSION; HALO-FEMORAL TRACTION; PULMONARY-FUNCTION; ANTERIOR INSTRUMENTATION; SURGERY; THORACOTOMY; CURVES; THORACOPLASTY; CARE;
D O I
10.1186/s12891-020-03233-1
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
BackgroundAdolescent idiopathic scoliosis (AIS) is the most common form of spinal deformity in children and adolescents which presents as complex three-dimensional (3D) deformity of the spine and rib cage. This study aimed to estimate the effectiveness and safety of surgical interventions for AIS using Bayesian meta-analysis.MethodsThe PubMed, EMBASE, and Cochrane Controlled Register of Trials were searched through Oct 1, 2019, without language restrictions. Relevant studies evaluating combined effectiveness and safety of surgical interventions for AIS were included according to eligibility criteria. The primary outcome measures included pulmonary function (change of absolute forced vital capacity and forced expiratory volume in 1 second from pre-operation to post-operation) and incidence of complications. The secondary outcome measure was change of Cobb angle from pre-operation to post-operation. Data was pooled using a random effects model in pairwise meta-analysis. Bayesian meta-analysis combined direct and indirect evidence using a Bayesian framework.ResultsTwenty-eight case-controlled studies with totally 1970 participants were included. This Bayesian meta-analysis combining direct and indirect evidences indicated that posterior fusion with instrumentation without thoracoplasty (PSF) had the highest probability to achieve better pulmonary function and lower complication rate; video assisted anterior fusion with instrumentation without thoracoplasty (VAT) had the highest probability to obtain better Cobb angle correction based on analysis of rank probability.ConclusionThis Bayesian meta-analysis demonstrated that PSF had the highest probability to achieve better post-surgical pulmonary function and lower complication rate, which gives a practical recommendation of PSF as a primary surgical treatment for AIS. The results also support statistics that current surgeries adopted more PSF but less open anterior approach surgery and thoracoplasty. More research work is required to address the effectiveness and safety of VAT for treating AIS more convincingly.
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页数:15
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