Decompression Alone Compared to Decompression With Fusion in Patients With Lumbar Spondylolisthesis: Systematic Review, Meta-Analysis, and Meta-Regression.
decompression
lumbar vertebra
spinal fusion
spondylolisthesis
Journal
International journal of spine surgery
ISSN: 2211-4599
Titre abrégé: Int J Spine Surg
Pays: Netherlands
ID NLM: 101579005
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
entrez:
22
3
2022
pubmed:
23
3
2022
medline:
23
3
2022
Statut:
ppublish
Résumé
We aimed to synthesize the latest evidence on the efficacy and safety of decompression alone compared to decompression with fusion in patients with lumbar spondylolisthesis. We also aimed to evaluate factors affecting the efficacy and complications. A systematic literature search was conducted using PubMed, Scopus, Europe PMC, Cochrane Central Database, and ClinicalTrials.gov. The main outcome was improvement in Oswestry Disability Index (ODI). The secondary outcome was back pain and leg pain improvement, complications, reoperation rate, duration of surgery, length of hospital stay, and blood loss. There were 3993 patients from 13 studies. Decompression with fusion was associated with greater reduction in ODI (mean difference 4.04 [95% CI 0.95, 7.13], Decompression with fusion had greater efficacy than decompression alone but was associated with more blood loss, lengthier surgery, and hospitalization. In terms of complications, decompression alone may be beneficial in younger patients. (PROSPERO CRD42020211904) LEVEL OF EVIDENCE: 2A.
Sections du résumé
BACKGROUND
BACKGROUND
We aimed to synthesize the latest evidence on the efficacy and safety of decompression alone compared to decompression with fusion in patients with lumbar spondylolisthesis. We also aimed to evaluate factors affecting the efficacy and complications.
METHODS
METHODS
A systematic literature search was conducted using PubMed, Scopus, Europe PMC, Cochrane Central Database, and ClinicalTrials.gov. The main outcome was improvement in Oswestry Disability Index (ODI). The secondary outcome was back pain and leg pain improvement, complications, reoperation rate, duration of surgery, length of hospital stay, and blood loss.
RESULTS
RESULTS
There were 3993 patients from 13 studies. Decompression with fusion was associated with greater reduction in ODI (mean difference 4.04 [95% CI 0.95, 7.13],
CONCLUSION
CONCLUSIONS
Decompression with fusion had greater efficacy than decompression alone but was associated with more blood loss, lengthier surgery, and hospitalization. In terms of complications, decompression alone may be beneficial in younger patients. (PROSPERO CRD42020211904) LEVEL OF EVIDENCE: 2A.
Identifiants
pubmed: 35314509
pii: 16/1/71
doi: 10.14444/8179
pmc: PMC9519074
doi:
Types de publication
Journal Article
Langues
eng
Pagination
71-80Informations de copyright
This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2022 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.
Déclaration de conflit d'intérêts
Declaration of Conflicting Interests: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.
Références
JAMA Netw Open. 2020 Sep 1;3(9):e2015015
pubmed: 32910195
N Engl J Med. 2016 Apr 14;374(15):1424-34
pubmed: 27074067
Spine (Phila Pa 1976). 2003 Feb 15;28(4):348-53
pubmed: 12590208
J Neurosurg Spine. 2004 Oct;1(3):267-72
pubmed: 15478364
J Orthop Sci. 2018 Jul;23(4):653-657
pubmed: 29699906
Indian J Orthop. 2018 Jul-Aug;52(4):358-362
pubmed: 30078892
Bone Joint J. 2013 Jul;95-B(7):960-5
pubmed: 23814250
Spine J. 2015 Apr 1;15(4):638-46
pubmed: 25450653
J Neurosurg Spine. 2018 Nov 30;30(2):234-241
pubmed: 30544348
Eur Spine J. 2002 Dec;11(6):571-4
pubmed: 12522715
J Bone Joint Surg Am. 2006 Dec;88(12):2714-20
pubmed: 17142422
Acta Neurochir (Wien). 2012 Jul;154(7):1205-12
pubmed: 22653494
Clin Spine Surg. 2018 Aug;31(7):E347-E352
pubmed: 29877872
Clin Spine Surg. 2018 Feb;31(1):E74-E79
pubmed: 28671881
N Engl J Med. 2016 Apr 14;374(15):1413-23
pubmed: 27074066
Eur Spine J. 2012 Feb;21(2):268-75
pubmed: 21786174
Eur Spine J. 2017 Feb;26(2):404-413
pubmed: 27421276
Bone Joint J. 2013 Jul;95-B(7):866-7
pubmed: 23814233
Arch Gerontol Geriatr. 2003 May-Jun;36(3):273-9
pubmed: 12849082
J Orthop Sci. 2005 May;10(3):270-6
pubmed: 15928889
Spine (Phila Pa 1976). 1994 Oct 1;19(19):2139-43
pubmed: 7809744
Clin Orthop Surg. 2020 Jun;12(2):187-193
pubmed: 32489540
Spine (Phila Pa 1976). 2017 Sep 15;42(18):E1077-E1086
pubmed: 28092340