摘要目的 系统评价单纯椎板减压与联合腰椎融合术治疗腰椎Ⅰ度滑脱并椎管狭窄效果.方法 计算机检索PubMed、Science Direct Online、Springer、CNKI、万方和维普,搜集有关的随机对照试验(RCT).由两位研究者按照纳入与排除标准筛选文献、提取资料和评价质量后,采用RevMan5.0软件进行Meta分析.结果 共纳入11个RCT,共1684例患者.与单纯椎板减压组比较,腰椎融合组术后1年腰痛的VAS评分降低[MD及其95％CI为-1.20(-1.57～-0.83),P<0.05];腰椎融合组的术后1年腿痛的VAS评分降低[MD及其95％CI为-0.88(-1.32～-0.44),P<0.05];腰椎融合组术后2年优良率较高[OR及其95％CI为1.65(1.13～2.41),P<0.05].而术后并发症、术后1年腰椎滑脱程度差异无统计学意义.结论 椎板减压联合腰椎融合术治疗腰椎Ⅰ度滑脱并椎管狭窄远期效果较单纯椎板减压满意.

abstractsObjective To analyze the effectiveness of laminectomy decompression compared with vertebral lamina decompression combined with lumbar fusion in Degree I spondylolisthesis and spinal canal stenosis. Methods PubMed, Science Direct Online, Springer, CNKI, Wan Fang and VIP were retrieved to collect relevant randomized controlled trials( RCT) . According to inclusion and exclusion criteria,two researchers screened literatures, extracted data and evaluated quality. RevMan5. 0 software was used for Meta analysis. A total of 11 RCT were included,with a total of 1684 patients. Meta analysis showed that compared with the simple laminectomy group,the VAS score of lumbar pain in the lumbar fusion group at 1 years after operation decreased ( MD and 95％CI:-1. 20(-1. 57--0. 83) ,P<0. 05) ,and the VAS score of the 1 year postoperative leg pain in the lumbar fusion group decreased(MD and 95％CI:-0. 88(-1. 32- -0. 44),P<0. 05),the excellent rate of lumbar fusion group at 2 years after operation was higher( OR and 95％CI:1. 65( 1. 13-2. 41) ,P<0. 05) . There was no significant difference in postoperative complications and lumbar spondylolisthesis at 1 years after operation. Conclusion In long term, compared with decompression alone, vertebral lamina decompression combined with lumbar fusion has more ideal effectiveness in the treatment.