Lumbar decompression and lumbar interbody fusion in the treatment of lumbar spinal stenosis
| Autor: | Wei Liu, Han Ke, Wen-Yi Zhu, Li Jian, Li-Hui Yang, Li-Kun An, Lei Zang, Shuo Yuan |
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| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
decompression fusion medicine.medical_specialty Visual analogue scale Decompression Operative Time Blood Loss Surgical lumbar spinal stenosis Cochrane Library law.invention 03 medical and health sciences Spinal Stenosis 0302 clinical medicine Lumbar Randomized controlled trial law medicine Humans 030212 general & internal medicine Lumbar Vertebrae business.industry Lumbar spinal stenosis General Medicine Length of Stay Decompression Surgical medicine.disease Surgery meta-analysis Spinal Fusion 030220 oncology & carcinogenesis Meta-analysis medicine.symptom business Claudication Systematic Review and Meta-Analysis Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | Background: The goal of this study was to review relevant randomized controlled trials in order to determine the efficacy of decompression and lumbar interbody fusion in the treatment of lumbar spinal stenosis. Method: Using appropriate keywords, we identified relevant studies in PubMed, the Cochrane library, and Embase. Key pertinent sources in the literature were also reviewed, and all articles published through July 2019 were considered for inclusion. For each study, we assessed odds ratios, mean difference, and 95% confidence interval to assess and synthesize outcomes. Result: Twenty-one randomized controlled trials were eligible for this meta-analysis with a total of 3636 patients. Compared with decompression, decompression and fusion significantly increased length of hospital stay, operative time and estimated blood loss. Compared with fusion, decompression significantly decreased operative time, estimated blood loss and overall visual analogue scale (VAS) scores. Compared with endoscopic decompression, microscopic decompression significantly increased length of hospital stay, and operative time. Compared with traditional surgery, endoscopic discectomy significantly decreased length of hospital stay, operative time, estimated blood loss, and overall VAS scores and increased Japanese Orthopeadic Association score. Compared with TLIF, MIS-TLIF significantly decreased length of hospital stay, and increased operative time and SF-36 physical component summary score. Compared with multi-level decompression and single level fusion, multi-level decompression and multi-level fusion significantly increased operative time, estimated blood loss and SF-36 mental component summary score and decreased Oswestry disability index score. Compared with decompression, decompression with interlaminar stabilization significantly decreased operative time and the score of Zurich claudication questionnaire symptom severity, and increased VAS score. Conclusion: Considering the limited number of included studies, we still need larger-sample, high-quality, long-term studies to explore the optimal therapy for lumbar spinal stenosis. |
| Databáze: | OpenAIRE |
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