Decompression with or with out concomitant fusion in lumbar stenosis as a result of degenerative spondylolisthesis: a scientific evaluate.
Eur Backbone J. 2018 Feb 05;:
Authors: Dijkerman ML, Overdevest GM, Moojen WA, Vleggeert-Lankamp CLA
PURPOSE: The first goal of this systematic evaluate is to match the result after decompression with and with out concomitant instrumented fusion in sufferers with lumbar stenosis and degenerative spondylolisthesis. Does including fusion to easy decompression result in higher outcomes?
METHODS: PubMed, Embase, CENTRAL, Cochrane, Internet of Science, CINAHL and Tutorial Search Premier had been searched. All research evaluating final result of decompression alone to decompression with concomitant-instrumented fusion in sufferers affected by symptomatic lumbar stenosis with degenerative spondylolisthesis had been included. Threat of bias was assessed utilizing an tailored model of the Cowley guidelines.
RESULTS: Eleven research had been included within the evaluation involving 3119 sufferers in whole. Within the majority of research, together with two RCTs, scientific final result of each affected person teams was comparable concerning most scientific final result measures.
CONCLUSION: At the moment there’s not sufficient proof that including instrumented fusion to a decompression results in superior outcomes in comparison with decompression solely in sufferers with lumbar stenosis and degenerative spondylolisthesis. A very powerful scientific final result measures, together with the ODI, present comparable outcomes. Due to this fact, the least invasive and least expensive process, being decompression alone, is most popular in sufferers with low-grade spondylolisthesis with predominant leg ache. These slides could be retrieved below Digital Supplementary Materials.
PMID: 29404693 [PubMed – as supplied by publisher]