Skip to main content
Erschienen in: European Spine Journal 1/2017

17.11.2016 | Letter to the Editor

Letter to the Editor concerning “Percutaneous versus traditional and paraspinal posterior open approaches for treatment of thoracolumbar fractures without neurologic deficit: a meta-analysis’’ by Sun, XY., Zhang, XN. & Hai, Y. Eur Spine J (2016). doi:10.1007/s00586-016-4818-4

verfasst von: Yongzhao Zhao, Guoxin Fan, Yanjie Zhu, Shisheng He

Erschienen in: European Spine Journal | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Excerpt

With great interest, we read the study entitled ‘Percutaneous versus traditional and paraspinal posterior open approaches for treatment of thoracolumbar fractures without neurologic deficit: a meta-analysis.’ published in European Spine Journal in October 2016 [1]. In this article, the authors evaluated differences in outcome variables between percutaneous, traditional, and paraspinal posterior open approaches for traumatic thoracolumbar fractures without neurologic deficit. It is a very interesting study. Nevertheless, we have some queries and would like to communicate with the authors.
1.
The perfect literature search strategy was essential for a great meta-analysis. However, the authors just described the search strategy using the keywords, such as “thoracolumbar fractures”, “lumbar fractures”, “percutaneous”, “minimally invasive”, “open”, “traditional”, “posterior”, “conventional”, “pedicle screw”, “sextant”, and “clinical trial”, without the issue of the completeness of the search strategy report for databases. Therefore, we suggest that the authors provide us a complete search strategy to strengthen the credibility of the study.
 
2.
As described in statistical analysis, the random-effects model was used if p < 0.05 was presented in the analysis. In the meta-analysis, significant heterogeneity was observed in the paraspinal subgroup analysis of intraoperative fluoroscopy (p = 0.04), paraspinal subgroup analysis of postoperative visual analog score (VAS) with follow-up time less than 1 week (p = 0.0006) and postoperative VAS with follow-up time from 1 week to 3 months (p < 0.00001). However, the authors chose the fixed-effects model other than random-effects model which was inconsistent with the methods described in statistical analysis. And we recalculated the datum using random-effects model and obtained results which differed from the Sun et al. study (Fig. 1). Therefore, in view of the significant heterogeneity, we suggest that “fixed-effects model” should be replaced by “random-effects model”.
 
3.
The assessment of publication bias was an important part in a meta-analysis. The authors declared that funnel plots were generated to determine publication bias. However, there were no relevant funnel plots in the results. As shown in Fig. 2, we generated the funnel plot of the analysis of postoperative VAS with follow-up time from 1 week to 3 months, and significant publication bias was observed. Obvious publication bias could heavily reduce the convincing of the results. Hence, we advise authors to add the funnel plots to complete this meta-analysis.
 
4.
In the meta-analysis, most included studies were carried out in China, therefore, the ethnic factor should be considered. We suggest that the authors should mention it in the conclusion.
 
Literatur
1.
Zurück zum Zitat Sun X-Y, Zhang X-N, Hai Y (2016) Percutaneous versus traditional and paraspinal posterior open approaches for treatment of thoracolumbar fractures without neurologic deficit: a meta-analysis. Eur Spine J 2016:1–14 Sun X-Y, Zhang X-N, Hai Y (2016) Percutaneous versus traditional and paraspinal posterior open approaches for treatment of thoracolumbar fractures without neurologic deficit: a meta-analysis. Eur Spine J 2016:1–14
Metadaten
Titel
Letter to the Editor concerning “Percutaneous versus traditional and paraspinal posterior open approaches for treatment of thoracolumbar fractures without neurologic deficit: a meta-analysis’’ by Sun, XY., Zhang, XN. & Hai, Y. Eur Spine J (2016). doi:10.1007/s00586-016-4818-4
verfasst von
Yongzhao Zhao
Guoxin Fan
Yanjie Zhu
Shisheng He
Publikationsdatum
17.11.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 1/2017
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4868-7

Weitere Artikel der Ausgabe 1/2017

European Spine Journal 1/2017 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.