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Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
Published on: February 9, 2024
Evaluating surgical interventions for low-grade degenerative lumbar spondylolisthesis: a network meta-analysis of
Yize Zhao1, Yong Huang1, Zhe Wang1
1Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Objective:
This study aimed to investigate which of the decompression alone (DA), decompression with fusion (DF), and decompression with dynamic stabilization (DS) produced the most favorable outcome for patients with low-grade degenerative lumbar spondylolisthesis (LDLS).
Material And Method:
Pubmed, Embase, Cochrane, and Web of Science were searched for all studies published before October 1, 2023. A review and data analysis of all randomized controlled trials (RCTs) of three interventions was performed by Stata (version 17.0) and Review Manager (version 5.4).
Result:
21 RCT studies with 3192 patients were included in the network meta-analysis. DA was superior to DF (MD = -92.05, P < 0.05; MD = -295.57, P < 0.05; MD = -2.19, P < 0.05; RR = 0.54, P < 0.05, respectively) and DS (MD = -35.69, P < 0.05; MD = -100.7, P < 0.05; MD = -295.57, P < 0.05; MD = -2.19, P < 0.05; RR = 0.54, P < 0.05, respectively) in reducing operative time, intraoperative blood loss, length of hospital stay, and postoperative adverse events. DS was superior to DF in reducing operative time, intraoperative blood loss, and length of hospital stay (MD = -56.35, P < 0.05; MD = -194.84, P < 0.05; MD = -1.12, P < 0.05, respectively). DF was superior to DA in reducing reoperations (RR = 0.55, p < 0.05). DF was superior to DA (MD = -1.44, p < 0.05) and DS (MD = -0.41, p < 0.05) in controlling the progression of olisthesis.
Conclusion:
DA was the most favorable treatment for LDLS, reducing operative time, bleeding, hospital stay, and postoperative complications. DF outperformed DA in reducing reoperation rates. Although DS showed benefits in operative time and bleeding compared to DF, it did not offer a significant advantage over DA.
