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Fusion Surgery for Lumbar Spondylolisthesis: A Systematic Review with Network Meta-analysis of RCTs – Lumbar Fusion

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The article systematically evaluated the optimal surgical fusion approach for lumbar spondylolisthesis by conducting a comprehensive search of various databases. The study included 15 Randomized Controlled Trials (RCTs) involving 892 patients, comparing different fusion techniques such as posterolateral fusion (PLF), posterior lumbar interbody fusion (PLIF), and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). The results indicated that MIS-TLIF had a significantly greater improvement in the Oswestry Disability Index (ODI) compared to endoscopic-TLIF, while PLIF had a better fusion effect than PLF. Overall, MIS-TLIF seemed to provide the greatest benefit to patients with lumbar spondylolisthesis, but the study highlighted the need for more high-quality, large-scale studies to further investigate the treatment efficacy of different fusion surgeries

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spine clinic in the world

Published article

: Among the various fusion surgeries for lumbar spondylolisthesis, MIS-TLIF appears to provide the greatest benefit to patients. However, more high-quality, large-scale studies are needed to further investigate the treatment efficacy of different fusion surgeries for lumbar spondylolisthesis.

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World Neurosurg. 2024 Feb 16:S1878-8750(24)00249-3. doi: 10.1016/j.wneu.2024.02.051. Online ahead of print.ABSTRACTOBJECTIVE: This study aimed to systematically evaluate the optimal surgical fusion approach for lumbar spondylolisthesis, to provide the latest and most reliable evidence for future clinical practice.METHODS: A comprehensive search of the PubMed, Ovid-Embase, Web of Science, Cochrane, and Scopus databases was conducted from inception,

World Neurosurg. 2024 Feb 16:S1878-8750(24)00249-3. doi: 10.1016/j.wneu.2024.02.051. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to systematically evaluate the optimal surgical fusion approach for lumbar spondylolisthesis, to provide the latest and most reliable evidence for future clinical practice.

METHODS: A comprehensive search of the PubMed, Ovid-Embase, Web of Science, Cochrane, and Scopus databases was conducted from inception to September 1, 2023, to identify relevant records. Two independent reviewers performed the literature screening, data extraction, and assessment of study quality.

RESULTS: Fifteen RCTs involving 892 patients met the inclusion criteria. The network evidence plot showed that posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF) were the most used fusion techniques. The network meta-analysis results revealed that minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) had a significantly greater improvement in the Oswestry Disability Index (ODI) compared to endoscopic-TLIF, while PLIF had a significantly better fusion effect than PLF. Furthermore, no statistically significant differences were observed between other fusion surgeries in terms of improving ODI, fusion rate, complications, or the improvement of visual analog scale-low back pain (VAS-LBP). The SURCA results indicated that MIS-TLIF had the greatest potential for improving ODI, VAS-LBP, and complications, while PLIF had the greatest potential for increasing fusion rates. However, the existing selection bias, measurement bias, reporting bias, and publication bias may have reduced the reliability of the meta-analysis results.

: Among the various fusion surgeries for lumbar spondylolisthesis, MIS-TLIF appears to provide the greatest benefit to patients. However, more high-quality, large-scale studies are needed to further investigate the treatment efficacy of different fusion surgeries for lumbar spondylolisthesis.

PMID:38369106 | DOI:10.1016/j.wneu.2024.02.051

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Fusion Surgery for Lumbar Spondylolisthesis: A Systematic Review with Network Meta-analysis of RCTs

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World Neurosurg. 2024 Feb 16:S1878-8750(24)00249-3. doi: 10.1016/j.wneu.2024.02.051. Online ahead of print.ABSTRACTOBJECTIVE: This study aimed to systematically evaluate the optimal surgical fusion approach for lumbar spondylolisthesis, to provide the latest and most reliable evidence for future clinical practice.METHODS: A comprehensive search of the PubMed, Ovid-Embase, Web of Science, Cochrane, and Scopus databases was conducted from inception
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