Response to: Does Combined Anterior-Posterior Approach Improve Outcomes Compared with Posterior-only Approach in Traumatic Thoracolumbar Burst Fractures?: A Systematic Review

摘要

We were pleased to hear that the readers found our articleto be interesting and relevant, and appreciate the opportunityto respond to their feedback [1].Their primary concern was the restriction of includedstudies to those that directly compared combined anterior-posteriorand posterior-only approaches, which resultedin the analysis of a relatively small number of datedstudies. As has been recommended in a number of guidelines[2,3], our systematic review protocol was developedprior to conducting the study and we were unaware thatonly a small number of studies would be eligible for inclusionat the time of methodology development. Althoughless restrictive inclusion and exclusion criteria were considered,we believe that this is likely to have resulted insubstantial heterogeneity among the included studies.When incorporated into a meta-analysis, study variabilityis widely accepted to have the capacity to influence theconclusions of a systematic review [2,3]. As such, it is possible,even likely, that the answer to the question raised bythe readers—“Would this alternative search strategy havechanged the outcome of this systematic review?”—is yes,which is why were so careful to include only comparativeinvestigations as a means of ensuring relative homogeneityamong included studies. Nevertheless, as observed by thereaders, the findings of our review confirm that there is apaucity of data upon which to base judgements regardingthe superiority, or otherwise, of combined anterior-posterioror posterior-only approaches in the managementof traumatic thoracolumbar burst fractures and furtherresearch is required to improve upon our understandingof this important question.