A systematic review of clinical outcomes in surgical treatment of adult isthmic spondylolisthesis

Noorian, Shaya; Sorensen, Karen; Cho, Woojin

doi:10.1016/j.spinee.2018.04.022

Cited by 47 publications

(49 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The overall confidence in the results of the 28 reviews was rated as “low” in 2 SRs 9 , 10 and “critically low” in the rest 11 - 36 ( Table 3 ). Critical appraisal of each SR is found in Table S2 in the supplemental material.…”

Section: Resultsmentioning

confidence: 99%

Critically Low Confidence in the Results Produced by Spine Surgery Systematic Reviews: An AMSTAR-2 Evaluation From 4 Spine Journals

Dettori

Skelly

Brodt

2020

Global Spine Journal

View full text Add to dashboard Cite

Study Design: A systematic cross-sectional survey of systematic reviews (SRs). Objective: To evaluate the methodological quality of spine surgery SRs published in 2018 using the updated AMSTAR 2 critical appraisal instrument. Methods: We identified the PubMed indexed journals devoted to spine surgery research in 2018. All SRs of spine surgical interventions from those journals were critically appraised for quality independently by 2 reviewers using the AMSTAR 2 instrument. We calculated the percentage of SRs achieving a positive response for each AMSTAR 2 domain item and assessed the levels of confidence in the results of each SR. Results: We identified 28 SRs from 4 journals that met our criteria for inclusion. Only 49.5% of the AMSTAR 2 domain items satisfied the AMSTAR 2 criteria. Critical domain items were satisfied less often (39.1%) compared with noncritical domain items (57.3%). Domain items most poorly reported include accounting for individual study risk of bias when interpreting results (14%), list and justification of excluded articles (18%), and an a priori establishment of methods prior to the review or registered protocol (18%). The overall confidence in the results was rated “low” in 2 SRs and “critically low” in 26. Conclusions: The credibility of a SR and its value to clinicians and policy makers are dependent on its methodological quality. This appraisal found significant methodological limitations in several critical domains, such that the confidence in the findings of these reviews is “critically low.”

show abstract

Section: Resultsmentioning

confidence: 99%

Critically Low Confidence in the Results Produced by Spine Surgery Systematic Reviews: An AMSTAR-2 Evaluation From 4 Spine Journals

Dettori

Skelly

Brodt

2020

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…A small case series of 6 patients with HGS demonstrated that in situ posterolateral and fibular interbody fusion was an efficacious treatment option for HGS because all patients had solid bony fusion, were asymptomatic, and had no slip progression at a minimum of 1-year follow-up. 40 Noorian et al 41 conducted a recent systematic review of clinical outcomes in the surgical treatment of adult isthmic spondylolisthesis, which included a total of 1538 patients from 6 randomized controlled trials and 9 observational studies. The authors concluded that the available studies provided strong evidence that the addition of reduction to fusion did not result in better clinical outcomes for pain and function.…”

Section: In Situ Fusionmentioning

confidence: 99%

High-Grade Spondylolisthesis in Adults: Current Concepts in Evaluation and Management

et al. 2020

View full text Add to dashboard Cite

Background: Information regarding the treatment of high-grade spondylolisthesis (HGS) in adults has been previously described; however, previous descriptions of the evaluation and surgical management of HGS do not represent more recent and now established approaches. The purpose of the current review is to discuss current concepts in the evaluation and management of patients with HGS. Methods: Literature review. Results: HGS is diagnosed in up to 11.3% of adults with spondylolisthesis and typically presents as nonspecific lower back pain. Regarding evaluation, a thorough history and physical examination should be performed, which may help predict the presence of HGS. Diagnostic imaging, and specifically the use of spino-pelvic parameters, are now commonly implicated in guiding treatment course and prognosis. When surgical intervention is indicated, surgical approaches include in situ fusion variations, reduction and partial reduction with fusion, and vertebrectomy. Although the majority of studies suggest improvements with these approaches, the literature is limited by a low level of evidence with regards to the superiority of one technique when compared with others. Conclusions: HGS is a unique cause of low back pain in adults that carries considerable morbidity, but rarely presents with neurologic symptoms. Although the definitions, classifications, and methods of diagnosis of this spinal deformity have been established and accepted, the ideal surgical management of this deformity remains highly debated. Fusion in situ techniques are often technically easier to perform and provide lower risk of neurologic complications, whereas reduction and fusion techniques offer greater restoration of global spino-pelvic balance. Preoperative spinopelvic parameters may have utility in assisting in procedural selection; however, future, higher-quality and longer-term studies are warranted to determine the optimal surgical intervention among the widely available techniques currently used, and to better define the indications for these interventions.

show abstract

“…38 -42 Similarly, the Short Form questionnaires (SF36), 34,35,43 Oswestry Disability Index (ODI), 35,36,44 and EuroQol Five Dimension questionnaire (EQ5D), 45,46 and so on, have frequently been used and validated in multiple populations to measure functional results and to quantify disability. 31,39 -41,47,48…”

Section: Reporting Of Outcomesmentioning

confidence: 99%

“…The visual analog scale (VAS) 35,36 and the numeric rating scale (NRS), 36,37 because of their ease of administration and validation in multiple studies, are commonly quoted in the literature as an indicator for levels of pain. [38][39][40][41][42] Similarly, the Short Form questionnaires (SF36), 34,35,43 Oswestry Disability Index (ODI), 35,36,44 and EuroQol Five Dimension questionnaire (EQ5D), 45,46 and so on, have frequently been used and validated in multiple populations to measure functional results and to quantify disability. 31,[39][40][41]47,48 While the ODI was developed primarily for the assessment of disability in patients with lumbar spinal pathologies, 49 first published in 1980 the questionnaire has been translated into numerous languages and its applicability as well as reliability have been validated over many studies.…”

Section: Reporting Of Outcomesmentioning

confidence: 99%

Quality and Safety Improvement in Spine Surgery

Jiang

Wilson

Badhiwala

et al. 2020

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Review article. Objectives: A narrative review of the literature on the current advances and limitations in quality and safety improvement initiatives in spine surgery. Methods: A comprehensive literature search was performed using Ovid MEDLINE focusing on 3 preidentified concepts: (1) quality and safety improvement, (2) reporting of outcomes and adverse events, and (3) prediction model and practice guidelines. The search was conducted under appropriate subject headings and using relevant text words. Articles were screened, and manuscripts relevant to this discussion were included in the narrative review. Results: Quality and safety improvement remains a major research focus attracting investigators from the global spine community. Multiple databases and registries have been developed for the purpose of generating data and monitoring the progress of quality and safety improvement initiatives. The development of various prediction models and clinical practice guidelines has helped shape the care of spine patients in the modern era. With the reported success of exemplary programs initiated by the Northwestern and Seattle Spine Team, other quality and safety improvement initiatives are anticipated to follow. However, despite these advancements, the reporting metrics for outcomes and adverse events remain heterogeneous in the literature. Conclusion: Constant surveillance and continuous improvement of the quality and safety of spine treatments is imperative in modern health care. Although great advancement has been made, issues with reporting outcomes and adverse events persist, and improvement in this regard is certainly needed.

show abstract

A systematic review of clinical outcomes in surgical treatment of adult isthmic spondylolisthesis

Cited by 47 publications

References 28 publications

Critically Low Confidence in the Results Produced by Spine Surgery Systematic Reviews: An AMSTAR-2 Evaluation From 4 Spine Journals

Critically Low Confidence in the Results Produced by Spine Surgery Systematic Reviews: An AMSTAR-2 Evaluation From 4 Spine Journals

High-Grade Spondylolisthesis in Adults: Current Concepts in Evaluation and Management

Quality and Safety Improvement in Spine Surgery

Contact Info

Product

Resources

About