摘要目的 回顾近年髂前下棘椎弓根钉棒内固定(anterior subcutaneous internal fixation,INFIX)技术相关文献,对其的整体预后疗效进行meta分析.方法 通过PubMed、万方、Google Scholar文献检索平台检索相关的文献进行meta分析,两名成员独立筛选符合条件的文献、进行文献质量评价并提取数据信息.数据信息包括人口统计学和手术信息、主要结果和次要结果,对筛选出的文章中大量的数据总结并meta分析.结果 共纳入20项研究,包含567例患者.6篇文献通过Majeed标准对临床结果进行评估,其中5篇文献具体描述了优良及一般预后人数,共185例,通过meta分析得到预后优良91%(95% CI ,0.8~1.03),预后一般9%(95% CI ,0.03~0.14).并发症:股外侧皮神经损害表现及异位骨化发生率较高,其余并发症发生率均＜5%.涉及异位性骨化并发症的文献共13篇,其中1篇并未提及发生无症状异位骨化的具体人数,其余12篇包括424例,包括132例异位骨化,异位骨化发生率26%(95% CI,0.11~0.40).567例中155例有明显股外侧皮神经损害表现,占25%(95% CI ,0.17~0.32),暂时性神经损害表现共124例,亚组分析后暂时性激惹发生率为21%(95% CI,0.14~0.28).5篇提及术后有股神经损害表现10例,发生率为3%(95% CI,-0.01~0.06).明确报道手术部位相关感染共18篇文献,包括534例中感染15例,感染率为3%(95% CI,0.02~0.04).19篇文献明确报道INIFX手术后内固定失败,包括32例由于不同的原因需要再次手术复位固定,内固定失败3%(95% CI ,0.02~0.04).报道骨折不预后数据14篇文献,共585例,其中治愈473例,3例发生骨不连接,分析得到发生骨折不愈合率为3%(95% CI ,0.01~0.05).结论 经INFIX骨盆手术后,通过对患者临床随访预后评分及影像学观察发现术后恢复较好,并且该新技术同时避免了许多传统骨盆外固定技术带来的不便及术后并发症,但也发现股外侧皮神经损害表现及异位性骨化表现发生率也较高.

abstractsObjective The related literatures on supra acetabular spinal pedicle screws and a subcutaneous connecting rod (INFIX) in recent years was reviewed, and the overall prognosis was analyzed by meta analysis. Methods literatures were ob?tained by searching the PubMed, Google Scholar, and Wanfang Full?text Database according to the criteria of inclusion and exclu?sion. The two members independently screened the qualified literature, evaluated the quality of the literature and extracted the da?ta information. The data information includes demographic and surgical information, main results and secondary results. A large number of data in the selected articles were analyzed and summarized by meta. Results A total of 20 studies were included, in?cluding 567 patients. The clinical results were evaluated by Majeed standard in 6 articles, of which 5 articles described the num?ber of excellent and general prognosis, including 185 patients. The excellent and good prognosis rate was 91% (95% CI : 80%-103% ) by meta analysis. The general prognosis rate was 9% (95% CI : 3%-14% ). Among the prognostic complications, the inci?dence of lateral femoral cutaneous nerve damage and heterotopic ossification was higher, and the incidence of other complications was less than 5%. There were 13 articles about the complications of ectopic ossification, of which 1 did not mention the specific number of asymptomatic heterotopic ossification, and the remaining 12 included 424 cases, including 132 cases of ectopic ossifica?tion. The incidence of ectopic ossification was 26% (95% CI: 11%-40%). Among the 567 cases, obvious symptoms of lateral femo?ral cutaneous nerve injury were reported. The patients with lateral femoral cutaneous nerve injury accounted for 25% (95% CI :17%-32%), and the temporary nerve damage was found in 124 cases. The incidence of temporary agitation after subgroup analysis was 21% (95% CI: 14%-28%). Five articles mentioned the manifestations of postoperative femoral nerve damage, including 10 pa?tients, the incidence of femoral nerve damage was 3% (95% CI:-1%-6%). A total of 18 articles on surgical site?related infections were reported, including 534 patients, of which 15 were infected, with an infection rate of 3% (95% CI: 2%-4%). 19 articles clear?ly reported the failure of internal fixation after INIFX operation, including 32 patients who needed reoperation for different rea?sons. The failure of internal fixation was 3% (95% CI: 2%-4%). A total of 585 cases of fracture non?prognosis data were reported, of which 473 cases were cured and 3 cases had bone nonunion. The non?union rate of fracture was 3% (95% CI: 1%-5%). Conclu?sion After InFix pelvic surgery, the patient's clinical follow?up prognosis score and imaging findings showed that the postopera?tive recovery was good, and the new technique also avoided the inconvenience and postoperative complications caused by many traditional pelvic external fixation techniques. However, it was also found that the lateral femoral cutaneous nerve damage and the incidence of heterotopic ossification were also higher.