A Bayesian network meta-analysis of 5 different fusion surgical procedures for the treatment of lumbar spondylolisthesis

Tang, Linjun; Wu, Yong; Jing, Daping; Xu, Yong; Wang, Cheng; Pan, Jingjing

doi:10.1097/md.0000000000019639

Cited by 9 publications

(6 citation statements)

References 39 publications

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“…5,[16][17][18][19][20][21][22] Nevertheless, in many of these studies, the participants were patients who had lumbar spinal stenosis both with and without degenerative spondylolisthesis or those who underwent both PLF and PLIF in the spinal arthrodesis group, and no sufficient studies target only PLIF as spinal arthrodesis, although reportedly, in a recent meta-analysis, PLIF is determined to be an optimal treatment for lumbar spondylolisthesis compared with PLF. 23 A combination of disease and procedures leads to confounding factors when comparing surgical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Comparing Investigation Between Bilateral Partial Laminectomy and Posterior Lumbar Interbody Fusion for Mild Degenerative Spondylolisthesis

Sugiura

Okuda

Takenaka

et al. 2020

Clinical Spine Surgery: A Spine Publication

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Objective: The present study aims to compare the surgical outcomes between bilateral partial laminectomy (BPL) and posterior lumbar interbody fusion (PLIF) in patients with mild degree of slippage. Summary of Background Data:To date, there have not been established surgical procedures for patients with mild degree of slippage. Moreover, sufficient studies that have compared surgical outcomes between BPL and PLIF are very few. Materials and Methods:In this retrospective study, the authors enrolled 202 consecutive patients with degenerative spondylolisthesis with slippage at L3 or L4 of > 3% who underwent spine surgery between 2005 and 2015. Patients were grouped into those who underwent single-segment PLIF (n = 106) and those who underwent BPL (n = 51). To adjust for potential confounders, the inverse probability of treatment weighting based on the propensity score was used. Surgical outcomes were compared between the BPL and PLIF groups. The threshold age for the final recovery rate of > 70% was evaluated using receiver operating characteristic curve analyses to assess the limit of age to achieve good outcomes. Patients who underwent reoperation in both groups were also evaluated.Results: Operation time and blood loss were significantly lower in the BPL group. The final recovery rate was similar between the groups without age stratification. The cutoff age to achieve a final recovery rate of > 70% was 75 years in the PLIF group, and the final recovery rate was significantly higher in the PLIF group than in the BPL group in patients aged less than 75 years but not in patients aged 75 years or older. In addition, the reoperation rate was similar between groups, and all reoperations in the PLIF group were for adjacent segment disease.Conclusions: BPL is one of the useful options in patients with mild degenerative spondylolisthesis, particularly in patients aged more than 75 years.

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Section: Discussionmentioning

confidence: 99%

Comparing Investigation Between Bilateral Partial Laminectomy and Posterior Lumbar Interbody Fusion for Mild Degenerative Spondylolisthesis

Sugiura

Okuda

Takenaka

et al. 2020

Clinical Spine Surgery: A Spine Publication

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“…Multiple surgical options have been proposed, including isthmic repair, PLF, and PLIF. 20,33 However, there is no consensus on which surgical treatment is the best. PLF and PLIF are amongst the most used fusion techniques.…”

Section: Discussionmentioning

confidence: 99%

Multiple-Level Low-Grade Lumbar Spondylolisthesis: Instrumented Posterolateral Fusion Using a Local Bone Graft

Said

Abdel-Wanis

Ameen

et al. 2020

Egyptian Spine Journal

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Background Data: Lumbar spondylolisthesis is a major cause of back pain. It occurs most commonly at only one spinal level. Multiple-level lumbar spondylolisthesis is uncommon, with few reports available in the literature. It can be treated by instrumented posterolateral fusion (PLF) using iliac crest bone graft (ICBG) with possible reported donor site complications. A reasonable alternative is local bone graft obtained from the laminae and spinous processes harvested during neural decompression. Purpose: To evaluate the outcome of multiple-level spondylolisthesis treated by PLF using a local bone graft. Study Design: Prospective clinical case series. Patients and Methods: Eleven patients (6 males and 5 females) with mean age 48.18 ± 9.7 years with multiple-level lumbar spondylolisthesis who underwent PLF using local bone graft in our University Hospital between 2015 and 2017 were evaluated. The mean duration of low back pain (LBP) was 11.36 ± 1.8 (range, 9-14) months. Operation time and blood loss were recorded. Clinical outcomes were evaluated using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), while fusion was evaluated using the Lenke classification for posterolateral fusion. Results: The mean operative time was 87.7 ± 19.1 minutes, while blood loss was 541.8 ± 135.5 ml, and the mean follow-up period was 34.55 ± 3.2 months. VAS and ODI improved significantly from preoperatively to postoperatively and at last follow-up (p < 0.05) with no significant difference in terms of gender or age. Radiologically, solid bone fusion was achieved in 23 out of 27 operated levels (85%). One screw was broken, and two patients had superficial wound infections. Conclusion: Our data suggest that instrumented PLF using local bone graft can effectively be used to manage multiple-level lumbar spondylolisthesis with satisfactory outcome and avoid ICBG donor site morbidity. (2020ESJ222)

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“…Lumbar interbody fusion surgery has been considered the classic surgical treatment for lumbar degenerative diseases requiring spinal stabilization and fusion, such as lumbar spinal stenosis, disk herniation, and spondylolisthesis [ 1 , 2 ]. This surgery may significantly relieve radicular symptoms and pain by removing nerve compression and providing spinal stabilization.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes and prediction nomogram model for postoperative hemoglobin < 80 g/L in patients following primary lumbar interbody fusion surgery

Xiong

Liu

et al. 2023

J Orthop Surg Res

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Objective To analyze the association between different postoperative hemoglobin (Hb) levels and postoperative outcomes in patients who have undergone primary lumbar interbody fusion, and to investigate the risk factors and establish a predictive nomogram mode for postoperative Hb < 80 g/L. Methods We retrospectively analyzed 726 cases who underwent primary lumbar interbody fusion surgery between January 2018 and December 2021in our hospital. All patients were divided into three groups according to the postoperative Hb levels (< 70 g/L, 70–79 g/L, ≥ 80 g/L). The postoperative outcomes among the three groups were compared, and the risk factors for postoperative Hb < 80 g/L were identified by univariate and multivariable logistic regression analysis. Based on these independent predictors, a nomogram model was developed. Predictive discriminative and accuracy ability of the predicting model was assessed using the concordance index (C-index) and calibration plot. Clinical application was validated using decision curve analysis. Internal validation was performed using the bootstrapping validation. Results Patients with postoperative Hb < 80 g/L had higher rates of postoperative blood transfusion, a greater length of stay, higher rates of wound complications, and higher hospitalization costs than those with postoperative Hb ≥ 80 g/L. Preoperative Hb, preoperative platelets, fusion segments, body mass index, operation time, and intraoperative blood loss independently were associated with postoperative Hb < 80 g/L. Intraoperative blood salvage was found to be a negative predictor for postoperative Hb < 80 g/L (OR, 0.21 [95% CI 0.09–0.50]). The area under the curve of the nomogram model was 0.950. After internal validations, the C-index of the model was 0.939. The DCA and calibration curve suggested that the nomogram model had a good consistency and clinical utility. Conclusions Postoperative Hb < 80 g/L in patients following primary lumbar interbody fusion surgery increased blood transfusions requirement and was independently associated with poor outcomes. A novel nomogram model was established and could conveniently predict the risk of postoperative Hb < 80 g/L in patients after this type of surgery.

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A Bayesian network meta-analysis of 5 different fusion surgical procedures for the treatment of lumbar spondylolisthesis

Abstract: Supplemental Digital Content is available in the text

Cited by 9 publications

References 39 publications

Comparing Investigation Between Bilateral Partial Laminectomy and Posterior Lumbar Interbody Fusion for Mild Degenerative Spondylolisthesis

Comparing Investigation Between Bilateral Partial Laminectomy and Posterior Lumbar Interbody Fusion for Mild Degenerative Spondylolisthesis

Multiple-Level Low-Grade Lumbar Spondylolisthesis: Instrumented Posterolateral Fusion Using a Local Bone Graft

Clinical outcomes and prediction nomogram model for postoperative hemoglobin < 80 g/L in patients following primary lumbar interbody fusion surgery

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