Fusion Surgery for Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations.
Decompression
Fusion
LS, Linkert scale
LSS, Lumbar spinal stenosis
Lumbar instability
Lumbar spinal stenosis
ODI, Oswestry Disability Index
RCT, Randomized controlled trial
SF-36, Short Form-36
Sedsign, Sedimentation sign
Spondylolisthesis
Journal
World neurosurgery: X
ISSN: 2590-1397
Titre abrégé: World Neurosurg X
Pays: United States
ID NLM: 101747743
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
27
01
2020
accepted:
11
03
2020
entrez:
3
7
2020
pubmed:
3
7
2020
medline:
3
7
2020
Statut:
epublish
Résumé
Lumbar spine stenosis represents a complex degenerative pathology that has been a subject of significant dispute when it comes to fusion. A review of the literature from 2008 to 2019 was performed on the role of fusion in the treatment of lumbar spinal stenosis using PubMed, Ovid Medline, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews. Using the key words "lumbar spinal stenosis," "lumbar fusion," "lumbar decompression," and "lumbar pedicle screw fixation," the search revealed 490 papers. Of these, only Level 1 or Level 2 evidence papers were selected, leading to only 3 randomized controlled trials (RCTs) that were analyzed. None of the good-quality studies (RCTs) performed so far have proven any clinical benefit of adding fusion to degenerative lumbar spine decompression. The effect of spinal instability on the outcome following decompression remains controversial. At present, no unanimous criteria exist among the RCTs to identify what constitutes true instability. Fusion for instability or stenosis alone remains controversial, and the results are unconvincing. At this point, the issue expands to not only lumbar degenerative diseases but spinal fractures and lumbar isthmic spondylolisthesis. We thereby present the consensus of the World Federation of Neurosurgical Societies Spine Committee, which formulated the indications for lumbar spine fusion in degenerative lumbar stenosis.
Identifiants
pubmed: 32613190
doi: 10.1016/j.wnsx.2020.100077
pii: S2590-1397(20)30008-9
pii: 100077
pmc: PMC7322802
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100077Informations de copyright
© 2020 The Authors.
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