The Status Of Abnormality Of Glycometabolism And Its Influence On Change Of Ambulatory Blood Pressure In 151 Patients With Hypertension

Objective To evaluate the efficacy of decompression with and without fusion in the treatment of lumbar disc herniation being received posterior approach. Methods We searched MEDLINE (1950 to Jun, 2007), OVID (1950 to Apr, 2007),PUBMED, the China Biological Medicine Database (1978 to Jun., 2007), WanFang Database (1981 to Feb., 2007),and hand-searched several related journals for randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCTs) involving the comparison of the outcomes between decompression with and without fusion in the treatment of lumbar disc herniation being received posterior approach. The quality of the included trials was assessed. RevMan 4.2.8 software was used for statistical analysis.Results Nine studies involving 1911 patients were included. The results of meta-analysis indicated that no statistically significant differences were observed as follows between the two operative procedures, including the result of incidence of postoperative leg pain [RR 0.94,95%CI (0.69,1.28) ], the result of incidence of re-operation[RR 0.77,95% CI (0.57, 1.04)]as well as the result of incidence of re-operation at other intervetebral space[RR 1.05,95% CI (0.49, 2.26)]. Scolisis [RR 1.23,95% CI (0.26,5.86)] in both groups is not difference . statistically significant differences were more observed in the non-fusion in the cumulative clinical outcome than that of fusion after being changed sub-category (using internal fixer) [RR =1.13,95% CI (1.05,1.21)]; The statistical significance was observed in the incidence of postoperative back pain [RR 0.70 , 95%CI (0.53,0.94)], but based on date with result I2=55.8% of heterogeneity test ; which revealed that decompression plus fusion was superior to decompression alone . The same result was obtained of incidence of re-operation at same intervetebral space in the fusion group , incidence of postoperative complications [RR 1.46,95% CI (1.06, 2.00)] and Sub-category of internal fixation in the total efficacy[RR =1.13,95% CI (1.05,1.21)] . Conclusions Although result obtained on the basis of CCT with a lager bias, We still conclude that there are no significant differences between the two procedures in clinical outcomes, incidences of postoperative leg pain, re-operation as well. the result of incidence of re-operation at other intervetebral space and scolisis after being first operated in both groups is not difference;Decompression with fusion leads to fewer patients suffering from both the incidence of postoperative back pain and incidence of re-operation at same intervetebral space and more complications than that of decompression alone. More high quality, large-scale randomized controlled trials are required for the accutate conclusion in treating lumbar disc herniation.