The necessity or not of the addition of fusion to decompression for lumbar degenerative spondylolisthesis patients: A PRISMA compliant meta-analysis
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(11):17 Medicine (Baltimore). 2021 Apr 9;100(14): e24775.What this means for my practice?
The results of this meta-analysis suggest that the addition of lumbar fusion to decompression does not provide an advantage in clinical outcomes when compared to decompression alone for patients suffering from lumbar degenerative spondylolisthesis. This study was limited by the small number of included studies, differing definitions of leg and back pain, and the inclusion of English studies only. Future high-quality randomized trials with larger sample sizes and longer follow-up are required.
Study Summary
Six randomized controlled trials containing a total of 650 lumbar degenerative spondylolisthesis patients were included in this meta-analysis comparing decompression plus lumbar fusion (n=375) to decompression alone (n=275). Pooled outcomes of interest included low back and leg pain improvement on the visual analogue scale (VAS), the Oswestry Disability Index (ODI) score, patient satisfaction, incidence of complications, incidence of re-operation, Euro-Qol 5-Dimension (EQ-5D) quality of life score, incidence of disease progression, and incidence of improved VAS pain scores. Results of this meta-analysis revealed no significant differences between the decompression plus lumbar fusion group compared to decompression alone for all pooled outcomes (p>0.05 for all).
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