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Clinical effectiveness of reduction and fusion versus in situ fusion in the management of degenerative lumbar spondylolisthesis: a systematic review and meta-analysis.
Wang, Dongfan; Wang, Wei; Han, Di; Muthu, Sathish; Cabrera, Juan P; Hamouda, Waeel; Ambrosio, Luca; Cheung, Jason P Y; Le, Hai V; Vadalà, Gianluca; Buser, Zorica; Wang, Jeffrey C; Cho, Samuel; Yoon, S Tim; Lu, Shibao; Chen, Xiaolong; Diwan, Ashish D.
Affiliation
  • Wang D; Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China.
  • Wang W; National Center for Clinical Research on Geriatric Diseases, No.45 Changchun Street, Xicheng District, Beijing, China.
  • Han D; Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China.
  • Muthu S; National Center for Clinical Research on Geriatric Diseases, No.45 Changchun Street, Xicheng District, Beijing, China.
  • Cabrera JP; Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China.
  • Hamouda W; National Center for Clinical Research on Geriatric Diseases, No.45 Changchun Street, Xicheng District, Beijing, China.
  • Ambrosio L; Orthopaedic Research Group, Coimbatore, Tamil Nadu, India.
  • Cheung JPY; Department of Orthopaedics, Government Medical College, Karur, Tamil Nadu, India.
  • Le HV; Department of Biotechnology, Faculty of Engineering, Karpagam Academy of Higher Education, Coimbatore, Tamil Nadu, India.
  • Vadalà G; Department of Neurosurgery, Hospital Clínico Regional de Concepción, Concepción, Chile.
  • Buser Z; Faculty of Medicine, University of Concepción, Concepción, Chile.
  • Wang JC; Department of Neurosurgery, Kasr Alainy Faculty of Medicine, Research and Teaching Hospitals, Cairo University, Cairo, Egypt.
  • Cho S; Neurological & Spinal Surgery Service, Security Forces Hospital, Dammam, Saudi Arabia.
  • Yoon ST; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
  • Lu S; Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
  • Chen X; Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.
  • Diwan AD; Department of Orthopaedic Surgery, University of California, Davis, CA, USA.
Eur Spine J ; 2023 Dec 03.
Article in En | MEDLINE | ID: mdl-38043128
ABSTRACT

PURPOSE:

To compare the clinical effectiveness of reduction and fusion with in situ fusion in the management of patients with degenerative lumbar spondylolisthesis (DLS).

METHODS:

The systematic review was conducted following the PRISMA guidelines. Relevant studies were identified from PubMed, Embase, Scopus, Cochrane Library, ClinicalTrials.gov, and Google Scholar. The inclusion criteria were (1) comparative studies of reduction and fusion versus in situ fusion for DLS patients, (2) outcomes reported as VAS/NRS, ODI, JOA score, operating time, blood loss, complication rate, fusion rate, or reoperation rate, (3) randomized controlled trials and observational studies published in English from the inception of the databases to January 2023. The exclusion criteria included (1) reviews, case series, case reports, letters, and conference reports, (2) in vitro biomechanical studies and computational modeling studies, (3) no report on study outcomes. The risk of bias 2 (RoB2) tool and the Newcastle-Ottawa scale was conducted to assess the risk of bias of RCTs and observational studies, respectively.

RESULTS:

Five studies with a total of 704 patients were included (375 reduction and fusion, 329 in situ fusion). Operating time was significantly longer in the reduction and fusion group compared to in situ fusion group (weighted mean difference 7.20; 95% confidence interval 0.19, 14.21; P = 0.04). No additional significant intergroup differences were noted in terms of other outcomes analyzed.

CONCLUSION:

While the reduction and fusion group demonstrated a statistically longer operating time compared to the in situ fusion group, the clinical significance of this difference was minimal. The findings suggest no substantial superiority of lumbar fusion with reduction over without reduction for the management of DLS.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Systematic_reviews Language: En Journal: Eur Spine J Journal subject: ORTOPEDIA Year: 2023 Document type: Article Affiliation country: China

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Systematic_reviews Language: En Journal: Eur Spine J Journal subject: ORTOPEDIA Year: 2023 Document type: Article Affiliation country: China