A Systematic Review and Meta-Analysis of Silicon Nitride and Biomaterial Modulus as it Relates to Subsidence Risk in Spinal Fusion Surgery
Notice bibliographique
Résumé
Introduction: For decades, researchers and surgeons have sought to determine the optimal biomaterial for spinal fusion implants. Successful fusion is associated with improved quality of life while failures are often associated with costly and complex revisions. One common failure is subsidence. Biomaterials with higher modulus are thought to be related to subsidence risk but this has not been thoroughly investigated. The aim of this systematic review and meta-analysis is to assess silicon nitride and biomaterial modulus as they relate to subsidence risk in spinal fusions. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Databases searched included PubMed-Medline, Google Scholar, Embase, EBSCO, and Cochrane Library. Study quality was assessed according to the Newcastle-Ottawa Scale. A network meta-analysis was chosen, allowing for direct and indirect comparisons for multiple treatments using a Bayesian hierarchical framework with Markov chain Monte Carlo methods. Outcomes were reported as odds ratios with 95% confidence intervals. Heterogeneity between studies was evaluated using the I 2 test. A pairwise meta-analysis was also produced to compare the results of network analysis for consistency. Publication bias was assessed using a funnel plot, Egger test, and Begg test. All analyses were conducted using R (Project for Statistical Computing, ver. 4.0.4). Results: The initial search yielded a total of 821 articles. After removal of duplicates and screening based on inclusion and exclusion criteria, 64 articles were available for review and 13 were selected for meta-analysis. Biomaterial implant types in the final studies included: silicon nitride (Si 3 N 4 ), polyetheretherketone (PEEK), titanium (Ti), and two composites, nano-hydroxyapatite/polyamide 66 (n-HA/PA66) and a carbon fiber reinforced polymer (CFRP). A total of 1,192 patients were included in this analysis -419 with titanium implants, 460 with PEEK, 96 with Si 3 N 4 , 332 with n-HA/PA66, and 35 with CFRP. Titanium had the highest rate of subsidence compared to other biomaterials. Pairwise analysis was consistent with these results. Both the Egger test (p = 0.28) and Begg test (p = 0.37) were found to be non-significant for publication bias. Conclusions: Spinal fusion implants derived from Si 3 N 4 , compared to PEEK and titanium, do not appear to be correlated with increased subsidence risk. sensible and economic. Improved healing and adequate fusion are associated with improved quality of life, faster return to work, less pain, less opiate use, and fewer repeat surgeries.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,013 | 0,005 |
| Bibliométrie | 0,001 | 0,004 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».