scholarly journals A Letter to the Editor Regarding “Fusion or Not for Degenerative Lumbar Spinal Stenosis: A Meta-Analysis and Systematic Review”

2018 ◽  
Vol 1 (21;1) ◽  
pp. E284-E287 ◽  
Author(s):  
Majid Reza Farrokhi
Keyword(s):  
Systematic Review ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Meta Analysis ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Letter To The Editor ◽  
Lumbar Spinal

scholarly journals Fusion or Not for Degenerative Lumbar Spinal Stenosis: A Meta-Analysis and Systematic Review

2018 ◽  
Vol 1 (21;1) ◽  
pp. 1-8
Author(s):  
Jie Hao
Keyword(s):  
Systematic Review ◽  
Spinal Fusion ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Fusion Surgery ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Lumbar Spinal

Background: Degenerative lumbar spinal stenosis (DLSS) is the main cause for chronic low back pain in the elderly. When refractory to conservative treatment, symptomatic patients commonly undergo surgery. However, whether or not fusion is a relatively better surgical option still remains unclear. Objective: The purpose of the present study was to systematically review the clinical outcomes of spinal decompression with or without spinal fusion for DLSS. Study Design: A systematic review of the therapeutic effect for DLSS with or without fusion. Methods: A literature search of 5 electronic databases was performed including PubMed, EMBASE, MEDLINE, Cochrane Library, and CENTRAL from inception to August 2016. Only randomized controlled trials (RCTs) assessing the comparison between decompression and fusion surgery for DLSS were included. Results: A total of 5 RCTs involving 438 patients met the inclusion criteria. Low-quality evidence of the meta-analysis was performed for the heterogeneity of the included studies. Pooled analysis showed no significant differences between decompression alone and fusion groups for the Oswestry Disability Index (ODI) scores at the baseline (P = 0.50) and 2 years follow-up (P = 0.71), and the satisfaction rate of operations was also similar for the groups (P = 0.53). However, operation time (P = 0.002), blood loss (P < 0.00001), and length of hospital stay (P = 0.007) were remarkably higher in the fusion group. Furthermore, there was no difference in the reoperation rate between these 2 groups at the latest follow-up (P = 0.49). Limitation: The methodological criteria and sample sizes were highly variable. The studies were heterogeneous. Conclusion: The present meta-analysis is the first to compare the efficacy of decompression alone and spinal fusion for the treatment of DLSS, including 5 RCTs. Our results demonstrate that additional fusion surgery seems unlikely to result in better outcomes for patients with DLSS, but it may increase additional risks and costs. High-quality homogeneous research is required to provide further evidence about surgical procedures for patients with DLSS. Key words: Decompression, fusion, lumbar spinal stenosis, meta-analysis

Management for lumbar spinal stenosis: A network meta-analysis and systematic review

2021 ◽  
Vol 85 ◽  
pp. 19-28 ◽  
Author(s):  
Fei-Long Wei ◽  
Cheng-Pei Zhou ◽  
Rui Liu ◽  
Kai-Long Zhu ◽  
Ming-Rui Du ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Meta Analysis ◽  
Lumbar Spinal

scholarly journals Effective of Fusion in the Treatment of Lumbar Spinal Stenosis：A Systematic Review Andmeta-Analysis

2021 ◽  
Author(s):  
Yang Yang ◽  
Shi-tian Tang ◽  
Qian Chen ◽  
fang chen
Keyword(s):  
Systematic Review ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Major Complication ◽  
Primary Objective ◽  
Leg Pain ◽  
Walking Ability ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Pain Scores ◽  
Lumbar Spinal

Abstract Objective: The debate on efficacy of fusion added to decompression for lumbar spinal stenosis (LSS) is ongoing. The primary objective of this systematic review is to compare the outcome after decompression with and without fusion in patients with lumbar spinal stenosis .Methods: A literature search was performed in the Web of Science, EMBASE, Pubmed,and Cochrane Libraryfrom January 1990 to May 2021.The information of screened studies included clinical outcomes, and secondary measures, then data synthesis and meta-analysis were progressed.Data analysis was conducted using the Review Manager 5.0 software.Results: 17 studies were included in the analysis involving 2947 patients in total. In the majority of studies, including seven RCTs and ten observational studies. The pooled data revealed that fusion was associated with signifificantly higher rates of back pain scores when compared with decompression alone in RCT subgroup(SMD=-0.42, 95% CI (–0.60, -0.23), Z=4.31 P<0.0001).However, fusion signifificantly increased the intraoperative blood loss, operative time and hospital stay. Both techniques had similar leg Pain scores , EQ-5D, walking ability，ODI，major complication,clinical satisfactions and reoperation rate.Conclusions: Our studies showed that the additional fusion in the management of LSS yielded no clinical improvements over decompression alone within a 1-year follow-up period. We suggested that the least invasive and least costly procedure, being decompression alone, is preferred in patients with degenerative lumbar spinal stenosis. The appropriate surgical protocol for LSS should be discussed further.

scholarly journals Prevalence of multimorbid degenerative lumbar spinal stenosis with knee and/or hip osteoarthritis: protocol for a systematic review and meta-analysis

2020 ◽  
Author(s):  
James J. Young ◽  
Jan Hartvigsen ◽  
Rikke K. Jensen ◽  
Ewa M. Roos ◽  
Carlo Ammendolia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Meta Analysis ◽  
Hip Osteoarthritis ◽  
Risk Of Bias ◽  
Sample Population ◽  
Prevalence Estimates ◽  
Lumbar Spinal ◽  
The Impact

Abstract Background: Lumbar spinal stenosis (LSS) and knee and hip osteoarthritis (OA) are prevalent conditions in the aging population and previous literature suggests they share many symptoms and are present at the same time in patients. However, no prevalence estimates of multimorbid LSS and knee and/or hip OA are currently available. The primary objective of this systematic review is therefore to estimate the prevalence of multimorbid LSS with knee and/or hip OA using radiological, clinical, and combined case definitions. Methods: This systematic review protocol has been designed according to the guidelines from the Cochrane Collaboration and are reported according the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. A comprehensive search will be performed in the following databases: MEDLINE, EMBASE, CENTRAL, and CINAHL. Web of Science will be used for forward citation tracking. No restriction in the search for publication data and language will be applied, but only articles in English will be included. The search strategy will include the following domains: LSS, knee OA, and hip OA. Retrieved citations will be screened by two authors independently. Disagreements will be discussed until consensus, or a third reviewer will be consulted if consensus cannot be reached. Data extraction and assessment of methodological quality will be done by two authors independently, using a standardized data extraction form and modified Risk of Bias Tool for Prevalence studies. Meta-analysis estimating prevalence with 95% CI will be performed using a random effects model. Meta-regression analyses will be performed to investigate the impact of LSS clinical presentations, sample population, healthcare setting, risk of bias, and other patient characteristics on prevalence estimates for multimorbid LSS and knee and/or hip OA. Discussion: The results of this review will provide the first estimates of the prevalence of multimorbid LSS and hip and knee OA based on various case definitions. The impact of covariates such as LSS clinical presentations, sample population, healthcare setting, risk of bias, and patient characteristics on prevalence estimates will also be presented. These findings will help to better understand the relationship between LSS and knee and/or hip OA and identify future research priorities. Systematic review registration: Submitted to PROSPERO, awaiting registration Keywords: Lumbar spinal stenosis, Hip osteoarthritis, Knee osteoarthritis, Multimorbidity, Prevalence, Systematic review protocol

Management of lumbar spinal stenosis: a systematic review and meta-analysis of rehabilitation, surgical, injection, and medication interventions

2022 ◽  
pp. 1-46
Author(s):  
Kaitlin Kirker ◽  
Michael F. Masaracchio ◽  
Parisa Loghmani ◽  
Rosa Elena Torres-Panchame ◽  
Michael Mattia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Meta Analysis ◽  
Lumbar Spinal
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