Comparability of Posterior Lumbar Interbody Fusion Versus Posterolateral Fusion for the Therapy of Isthmic Spondylolisthesis.
Clin Backbone Surg. 2017 Aug;30(7):E915-E922
Authors: Luo J, Cao Okay, Yu T, Li L, Huang S, Gong M, Cao C, Zou X
STUDY DESIGN: Systematic evaluation and meta-analysis.
BACKGROUND: Posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF) have been broadly used within the therapy of lumbar isthmic spondylolisthesis (IS). There was an important controversy over the popular fusion methodology.
OBJECTIVE: The aim of this research is to guage the scientific outcomes between PLF and PLIF for the therapy of IS.
MATERIALS AND METHODS: Associated research that in contrast the scientific effectiveness of PLIF and PLF for the therapy of IS have been acquired by a complete search in four digital databases (PubMed, EMBASE, Cochrane Managed Trial Register, and MEDLINE) from January 1950 by December 2014. Included research have been carried out in line with eligibility standards. The principle endpoints included: enchancment of scientific satisfaction, complication charge, reoperation charge, fusion charge, and reoperation charge.
RESULTS: A complete of 9 research have been included within the meta-analysis; 6 have been low-quality proof and a pair of have been high-quality proof as indicated by the Jadad scale. In contrast with PLIF, PLF sufferers confirmed decrease fusion charges [P=0.005, odds ratio (OR)=0.29 (0.14, 0.58)] and shorter operation instances [P<0.00001, weighted mean difference (WMD)=-0.5(-0.61, -0.39)]. No vital distinction was discovered within the time period of postoperative visible analogue scale leg rating [P=0.92, WMD=0.02 (-0.39, 0.44)] and visible analogue reduce rating [P=0.41, WMD=0.20 (-0.28, 0.68)], blood loss [P=0.39, WMD=121.17 (-152.68, 395.01)], complication charge [P=0.42, OR=1.50 (0.56, 4.03)], postoperative Oswestry Incapacity Index [P=0.3, WMD=1.09 (-0.97, 3.15)], and postoperative scientific satisfaction [P=0.84, OR=1.06 (0.60, 1.86)].
CONCLUSIONS: In conclusion, our meta-analysis advised that PLF reveals vital decrease fusion charge in contrast with PLIF. Though PLIF had extra operation time than PLF, there was no vital distinction in international evaluation of scientific final result between the two fusion procedures. Nonetheless, future well-designed, randomized-controlled trials are nonetheless wanted to additional verify our outcomes.
PMID: 28746129 [PubMed – indexed for MEDLINE]