Posterior lumbar interbody fusion versus interspinous stabilization in lumbar spinal stenosis: a meta-analysis.

Study Summary

19 studies involving 214155 patients with lumbar spinal stenosis (LSS) were included in this systematic review and meta-analysis comparing posterior lumbar interbody fusion (PLIF) with interspinous stabilization (ISS). Pooled outcomes included pain measured using the Visual Analog Scale (VAS), functional disability measured using the Oswestry Disability Index (ODI), segmental range of motion (ROM), reoperation and revision rates, operative time, blood loss, hospital stay, and complications. Both procedures demonstrated comparable short- and mid-term improvements in pain and disability, with no significant differences in reoperation or revision rates. However, ISS was associated with shorter operative times, reduced blood loss, shorter hospital stays, and fewer overall complications, while PLIF demonstrated greater changes in segmental ROM. These findings suggested that ISS offered a less invasive surgical alternative with comparable clinical outcomes and a more favourable perioperative safety profile in appropriately selected patients.