Anterior, Posterior and Anterior–Posterior Approaches for the Treatment of Thoracolumbar Burst Fractures: A Network Meta-Analysis of Randomized Controlled Trials
Purpose To compare the clinical and radiological results of the anterior approach versus the posterior approach versus the anterior–posterior approach for the treatment of thoracolumbar burst fractures.Methods The network meta-analysis was performed in accordance with the PRISMA Statement. Electroni...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-01-01
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| Series: | Journal of Investigative Surgery |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/08941939.2024.2301794 |
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| author | Yuchen Duan Dagang Feng Jun Chen Yamei Wu Tong Li Leiming Jiang Yong Huang |
| author_facet | Yuchen Duan Dagang Feng Jun Chen Yamei Wu Tong Li Leiming Jiang Yong Huang |
| author_sort | Yuchen Duan |
| collection | DOAJ |
| description | Purpose To compare the clinical and radiological results of the anterior approach versus the posterior approach versus the anterior–posterior approach for the treatment of thoracolumbar burst fractures.Methods The network meta-analysis was performed in accordance with the PRISMA Statement. Electronic searches of PubMed and Embase were conducted up to June 22, 2023, for relevant randomized controlled trials. STATA13.0 was used to perform network meta-analysis. p < .05 was considered significant.Results Nine RCTs with a total of 550 patients receiving surgical treatment in at least two of the three approaches, including anterior, posterior and anterior–posterior approaches, were included. The surgical duration and intraoperative bleeding volume in the posterior approach were significantly lower than those in the anterior (SMD, −1.72; 95% CI, −2.82, −0.62) and anterior–posterior approaches (SMD, 3.33; 95% CI, 1.65, 5.00). The surgical duration in the anterior approach was significantly lower than that in the anterior–posterior approach (SMD, 1.61; 95% CI, 0.12, 3.10). The Cobb angle in the anterior–posterior approach was significantly lower than that in the anterior approach (MD, −4.83; 95% CI, −9.60, −0.05). The VAS score in the posterior approach was significantly higher than that in the anterior approach (MD, 0.85; 95% CI, 0.55, 1.16) and anterior–posterior approach (MD, −0.84; 95% CI, −1.12, −0.55). No significant difference was identified among the three surgical approaches in implant failure rate and infection rate.Conclusion All three approaches were safe approaches with advantages and disadvantages. The selection of surgical approaches for the treatment of thoracolumbar burst fractures may be individualized. |
| format | Article |
| id | doaj-art-a66d20c8fe4c48f5a757aa1cbce7f82f |
| institution | Kabale University |
| issn | 0894-1939 1521-0553 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj-art-a66d20c8fe4c48f5a757aa1cbce7f82f2024-12-23T07:54:06ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532024-01-0137110.1080/08941939.2024.2301794Anterior, Posterior and Anterior–Posterior Approaches for the Treatment of Thoracolumbar Burst Fractures: A Network Meta-Analysis of Randomized Controlled TrialsYuchen Duan0Dagang Feng1Jun Chen2Yamei Wu3Tong Li4Leiming Jiang5Yong Huang6Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, ChinaDepartment of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, ChinaDepartment of Critical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, ChinaSichuan Academy of Chinese Medicine Sciences, Chengdu, ChinaDepartment of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, ChinaDepartment of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, ChinaDepartment of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, ChinaPurpose To compare the clinical and radiological results of the anterior approach versus the posterior approach versus the anterior–posterior approach for the treatment of thoracolumbar burst fractures.Methods The network meta-analysis was performed in accordance with the PRISMA Statement. Electronic searches of PubMed and Embase were conducted up to June 22, 2023, for relevant randomized controlled trials. STATA13.0 was used to perform network meta-analysis. p < .05 was considered significant.Results Nine RCTs with a total of 550 patients receiving surgical treatment in at least two of the three approaches, including anterior, posterior and anterior–posterior approaches, were included. The surgical duration and intraoperative bleeding volume in the posterior approach were significantly lower than those in the anterior (SMD, −1.72; 95% CI, −2.82, −0.62) and anterior–posterior approaches (SMD, 3.33; 95% CI, 1.65, 5.00). The surgical duration in the anterior approach was significantly lower than that in the anterior–posterior approach (SMD, 1.61; 95% CI, 0.12, 3.10). The Cobb angle in the anterior–posterior approach was significantly lower than that in the anterior approach (MD, −4.83; 95% CI, −9.60, −0.05). The VAS score in the posterior approach was significantly higher than that in the anterior approach (MD, 0.85; 95% CI, 0.55, 1.16) and anterior–posterior approach (MD, −0.84; 95% CI, −1.12, −0.55). No significant difference was identified among the three surgical approaches in implant failure rate and infection rate.Conclusion All three approaches were safe approaches with advantages and disadvantages. The selection of surgical approaches for the treatment of thoracolumbar burst fractures may be individualized.https://www.tandfonline.com/doi/10.1080/08941939.2024.2301794anterior approachanterior–posterior approachmeta-analysisposterior approachthoracolumbar burst fractures |
| spellingShingle | Yuchen Duan Dagang Feng Jun Chen Yamei Wu Tong Li Leiming Jiang Yong Huang Anterior, Posterior and Anterior–Posterior Approaches for the Treatment of Thoracolumbar Burst Fractures: A Network Meta-Analysis of Randomized Controlled Trials Journal of Investigative Surgery anterior approach anterior–posterior approach meta-analysis posterior approach thoracolumbar burst fractures |
| title | Anterior, Posterior and Anterior–Posterior Approaches for the Treatment of Thoracolumbar Burst Fractures: A Network Meta-Analysis of Randomized Controlled Trials |
| title_full | Anterior, Posterior and Anterior–Posterior Approaches for the Treatment of Thoracolumbar Burst Fractures: A Network Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Anterior, Posterior and Anterior–Posterior Approaches for the Treatment of Thoracolumbar Burst Fractures: A Network Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Anterior, Posterior and Anterior–Posterior Approaches for the Treatment of Thoracolumbar Burst Fractures: A Network Meta-Analysis of Randomized Controlled Trials |
| title_short | Anterior, Posterior and Anterior–Posterior Approaches for the Treatment of Thoracolumbar Burst Fractures: A Network Meta-Analysis of Randomized Controlled Trials |
| title_sort | anterior posterior and anterior posterior approaches for the treatment of thoracolumbar burst fractures a network meta analysis of randomized controlled trials |
| topic | anterior approach anterior–posterior approach meta-analysis posterior approach thoracolumbar burst fractures |
| url | https://www.tandfonline.com/doi/10.1080/08941939.2024.2301794 |
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