Outcomes of Expandable Interbody Devices in Lumbar Fusion: A Systematic Review and Meta-analysis.
Clin Spine Surg
; 33(6): 230-243, 2020 07.
Article
en En
| MEDLINE
| ID: mdl-32101992
ABSTRACT
STUDY DESIGN:
This was a systematic review.OBJECTIVE:
The objective of this study was to review radiographic, clinical, and surgical outcomes of expandable interbody device implantation following lumbar fusion. SUMMARY OF BACKGROUND DATA Few studies have evaluated postsurgical outcomes of expandable implants following lumbar interbody fusion.METHODS:
A systematic review was performed to identify studies investigating expandable intervertebral body devices in lumbar fusion. Radiographic parameters, fusion assessments, patient-reported outcomes (PROs), complications, and revision data were recorded. A comparison of expandable and static devices was performed using a meta-analysis.RESULTS:
Eleven articles were included. Postoperative improvements for each radiographic parameters for expandable versus static device implantation ranged from lumbar lordosis, +2.0 to +5.0 degrees (expandable) versus +1.0 to +4.4 degrees (static); segmental lordosis, +1.0 to +5.2 degrees (expandable) versus+1.1 to +2.3 degrees (static); disk height, +0.82 to +4.8 mm (expandable) versus +0.26 to +6.9 mm (static); foraminal height, +0.13 to +2.8 mm (expandable) versus and +0.05 to +3.0 mm (static). Fusion rates ranged from 72.1% at 6 months to 100% at terminal follow-up. Preoperative to final follow-up improvement for the various PROs assessed were Oswestry Disability Index, -15.4 to -56.3 (expandable) versus -13.6 to -26.3 (static); Visual Analog Scale (VAS) Back, -3.2 to -6.0 (expandable) versus -3.1 to -4.1 (static); and VAS Leg, -2.9 to -7.1 (expandable) -3.0 versus -4.8 (static). Static cages had a reported complication rate ranging from 6.0% to 16.1% and a subsidence rate of 6.0%. Expandable cages had a reported complication rate that ranged from 0.0.% to 10.0% and a subsidence rate of 5.5%-10.0%. A meta-analysis demonstrated a statistically significant difference in the PRO Oswestry Disability Index, but not VAS Back, VAS Leg, or radiographic outcomes (disk height or foraminal height).CONCLUSION:
There is no clear evidence for the use of expandable interbody devices over static devices.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fusión Vertebral
/
Fijadores Internos
/
Lordosis
/
Vértebras Lumbares
/
Región Lumbosacra
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Systematic_reviews
Aspecto:
Patient_preference
Límite:
Humans
Idioma:
En
Revista:
Clin Spine Surg
Año:
2020
Tipo del documento:
Article
País de afiliación:
Israel