Is reduction better than arthrodesis in situ in surgical management of low-grade spondylolisthesis? A system review and meta analysis
Purpose To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis. Methods We performed a comprehensive search of both observational and randomized clinical trials published up to April 2016 in PubMed, MEDLINE, Cochrane L...
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| Veröffentlicht in: | European spine journal Jg. 26; H. 3; S. 606 - 618 |
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| Hauptverfasser: | , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
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Berlin/Heidelberg
Springer Berlin Heidelberg
01.03.2017
Springer Nature B.V |
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| ISSN: | 0940-6719, 1432-0932, 1432-0932 |
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| Abstract | Purpose
To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis.
Methods
We performed a comprehensive search of both observational and randomized clinical trials published up to April 2016 in PubMed, MEDLINE, Cochrane Library, and Embase databases. The outcomes included age, sex, operative time, blood loss, and at least 2 years clinical results of Oswestry disability index (ODI), visual analogue scale (VAS), lumbar lordosis, slippage, fusion rate, the rate of good and excellent and the complication rate. Two authors independently extracted the articles and the predefined data.
Results
Seven eligible studies, involving four RCTs and three cohort studies were included in this systematic review and meta-analysis. Patients who underwent reduction did achieved better slippage correction comparing with arthrodesis in situ (
P
< 0.00001). However, there was no significant difference in the case of operative time, blood loss, VAS (
P
= 0.36), ODI (
P
= 0.50), lumbar lordosis (
P
= 0.47), the rate of good and excellent (
P
= 0.84), fusion rate (
P
= 0.083) and complication rate (
P
= 0.33) between the arthrodesis in situ group and the reduction group.
Conclusions
On the basis on this review, arthrodesis after reduction of low-grade spondylolisthesis potentially reduced vertebral slippage. Reduction was neither associated with a longer operative time nor more blood loss. There was no significant difference in the outcomes between reduction and arthrodesis in situ group. Both procedures could be expected to achieve good clinical result.
Level of evidence
Therapeutic Level IIa. |
|---|---|
| AbstractList | To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis.PURPOSETo compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis.We performed a comprehensive search of both observational and randomized clinical trials published up to April 2016 in PubMed, MEDLINE, Cochrane Library, and Embase databases. The outcomes included age, sex, operative time, blood loss, and at least 2 years clinical results of Oswestry disability index (ODI), visual analogue scale (VAS), lumbar lordosis, slippage, fusion rate, the rate of good and excellent and the complication rate. Two authors independently extracted the articles and the predefined data.METHODSWe performed a comprehensive search of both observational and randomized clinical trials published up to April 2016 in PubMed, MEDLINE, Cochrane Library, and Embase databases. The outcomes included age, sex, operative time, blood loss, and at least 2 years clinical results of Oswestry disability index (ODI), visual analogue scale (VAS), lumbar lordosis, slippage, fusion rate, the rate of good and excellent and the complication rate. Two authors independently extracted the articles and the predefined data.Seven eligible studies, involving four RCTs and three cohort studies were included in this systematic review and meta-analysis. Patients who underwent reduction did achieved better slippage correction comparing with arthrodesis in situ (P < 0.00001). However, there was no significant difference in the case of operative time, blood loss, VAS (P = 0.36), ODI (P = 0.50), lumbar lordosis (P = 0.47), the rate of good and excellent (P = 0.84), fusion rate (P = 0.083) and complication rate (P = 0.33) between the arthrodesis in situ group and the reduction group.RESULTSSeven eligible studies, involving four RCTs and three cohort studies were included in this systematic review and meta-analysis. Patients who underwent reduction did achieved better slippage correction comparing with arthrodesis in situ (P < 0.00001). However, there was no significant difference in the case of operative time, blood loss, VAS (P = 0.36), ODI (P = 0.50), lumbar lordosis (P = 0.47), the rate of good and excellent (P = 0.84), fusion rate (P = 0.083) and complication rate (P = 0.33) between the arthrodesis in situ group and the reduction group.On the basis on this review, arthrodesis after reduction of low-grade spondylolisthesis potentially reduced vertebral slippage. Reduction was neither associated with a longer operative time nor more blood loss. There was no significant difference in the outcomes between reduction and arthrodesis in situ group. Both procedures could be expected to achieve good clinical result.CONCLUSIONSOn the basis on this review, arthrodesis after reduction of low-grade spondylolisthesis potentially reduced vertebral slippage. Reduction was neither associated with a longer operative time nor more blood loss. There was no significant difference in the outcomes between reduction and arthrodesis in situ group. Both procedures could be expected to achieve good clinical result.Therapeutic Level IIa.LEVEL OF EVIDENCETherapeutic Level IIa. Purpose To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis. Methods We performed a comprehensive search of both observational and randomized clinical trials published up to April 2016 in PubMed, MEDLINE, Cochrane Library, and Embase databases. The outcomes included age, sex, operative time, blood loss, and at least 2 years clinical results of Oswestry disability index (ODI), visual analogue scale (VAS), lumbar lordosis, slippage, fusion rate, the rate of good and excellent and the complication rate. Two authors independently extracted the articles and the predefined data. Results Seven eligible studies, involving four RCTs and three cohort studies were included in this systematic review and meta-analysis. Patients who underwent reduction did achieved better slippage correction comparing with arthrodesis in situ (P < 0.00001). However, there was no significant difference in the case of operative time, blood loss, VAS (P = 0.36), ODI (P = 0.50), lumbar lordosis (P = 0.47), the rate of good and excellent (P = 0.84), fusion rate (P = 0.083) and complication rate (P = 0.33) between the arthrodesis in situ group and the reduction group. Conclusions On the basis on this review, arthrodesis after reduction of low-grade spondylolisthesis potentially reduced vertebral slippage. Reduction was neither associated with a longer operative time nor more blood loss. There was no significant difference in the outcomes between reduction and arthrodesis in situ group. Both procedures could be expected to achieve good clinical result. Level of evidence Therapeutic Level IIa. To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis. We performed a comprehensive search of both observational and randomized clinical trials published up to April 2016 in PubMed, MEDLINE, Cochrane Library, and Embase databases. The outcomes included age, sex, operative time, blood loss, and at least 2 years clinical results of Oswestry disability index (ODI), visual analogue scale (VAS), lumbar lordosis, slippage, fusion rate, the rate of good and excellent and the complication rate. Two authors independently extracted the articles and the predefined data. Seven eligible studies, involving four RCTs and three cohort studies were included in this systematic review and meta-analysis. Patients who underwent reduction did achieved better slippage correction comparing with arthrodesis in situ (P < 0.00001). However, there was no significant difference in the case of operative time, blood loss, VAS (P = 0.36), ODI (P = 0.50), lumbar lordosis (P = 0.47), the rate of good and excellent (P = 0.84), fusion rate (P = 0.083) and complication rate (P = 0.33) between the arthrodesis in situ group and the reduction group. On the basis on this review, arthrodesis after reduction of low-grade spondylolisthesis potentially reduced vertebral slippage. Reduction was neither associated with a longer operative time nor more blood loss. There was no significant difference in the outcomes between reduction and arthrodesis in situ group. Both procedures could be expected to achieve good clinical result. Therapeutic Level IIa. To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis. We performed a comprehensive search of both observational and randomized clinical trials published up to April 2016 in PubMed, MEDLINE, Cochrane Library, and Embase databases. The outcomes included age, sex, operative time, blood loss, and at least 2 years clinical results of Oswestry disability index (ODI), visual analogue scale (VAS), lumbar lordosis, slippage, fusion rate, the rate of good and excellent and the complication rate. Two authors independently extracted the articles and the predefined data. Seven eligible studies, involving four RCTs and three cohort studies were included in this systematic review and meta-analysis. Patients who underwent reduction did achieved better slippage correction comparing with arthrodesis in situ (P < 0.00001). However, there was no significant difference in the case of operative time, blood loss, VAS (P = 0.36), ODI (P = 0.50), lumbar lordosis (P = 0.47), the rate of good and excellent (P = 0.84), fusion rate (P = 0.083) and complication rate (P = 0.33) between the arthrodesis in situ group and the reduction group. On the basis on this review, arthrodesis after reduction of low-grade spondylolisthesis potentially reduced vertebral slippage. Reduction was neither associated with a longer operative time nor more blood loss. There was no significant difference in the outcomes between reduction and arthrodesis in situ group. Both procedures could be expected to achieve good clinical result. Therapeutic Level IIa. Purpose To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis. Methods We performed a comprehensive search of both observational and randomized clinical trials published up to April 2016 in PubMed, MEDLINE, Cochrane Library, and Embase databases. The outcomes included age, sex, operative time, blood loss, and at least 2 years clinical results of Oswestry disability index (ODI), visual analogue scale (VAS), lumbar lordosis, slippage, fusion rate, the rate of good and excellent and the complication rate. Two authors independently extracted the articles and the predefined data. Results Seven eligible studies, involving four RCTs and three cohort studies were included in this systematic review and meta-analysis. Patients who underwent reduction did achieved better slippage correction comparing with arthrodesis in situ ( P < 0.00001). However, there was no significant difference in the case of operative time, blood loss, VAS ( P = 0.36), ODI ( P = 0.50), lumbar lordosis ( P = 0.47), the rate of good and excellent ( P = 0.84), fusion rate ( P = 0.083) and complication rate ( P = 0.33) between the arthrodesis in situ group and the reduction group. Conclusions On the basis on this review, arthrodesis after reduction of low-grade spondylolisthesis potentially reduced vertebral slippage. Reduction was neither associated with a longer operative time nor more blood loss. There was no significant difference in the outcomes between reduction and arthrodesis in situ group. Both procedures could be expected to achieve good clinical result. Level of evidence Therapeutic Level IIa. |
| Author | Li, Xiaochuan Ruan, Dike Bai, Xuedong Wu, Yaohong Wang, Deli Liu, Liyang Chen, Jiahai |
| Author_xml | – sequence: 1 givenname: Xuedong surname: Bai fullname: Bai, Xuedong organization: Department of Orthopedic Surgery, Navy General Hospital – sequence: 2 givenname: Jiahai surname: Chen fullname: Chen, Jiahai organization: Department of Orthopedics Surgery, Xijing Hospital, The Fourth Military Medical University – sequence: 3 givenname: Liyang surname: Liu fullname: Liu, Liyang organization: Department of Orthopedic Surgery, Navy General Hospital – sequence: 4 givenname: Xiaochuan surname: Li fullname: Li, Xiaochuan organization: Department of Orthopedic Surgery, Navy General Hospital – sequence: 5 givenname: Yaohong surname: Wu fullname: Wu, Yaohong organization: Department of Orthopedic Surgery, Navy General Hospital – sequence: 6 givenname: Deli surname: Wang fullname: Wang, Deli organization: Department of Orthopedic Surgery, Navy General Hospital – sequence: 7 givenname: Dike surname: Ruan fullname: Ruan, Dike email: ruandikengh@163.com organization: Department of Orthopedic Surgery, Navy General Hospital |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27832362$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1007_s00586_023_08041_4 crossref_primary_10_1016_j_otsr_2022_103541 crossref_primary_10_1007_s00402_019_03282_9 crossref_primary_10_1007_s00586_017_5435_6 crossref_primary_10_3389_fmed_2024_1350064 crossref_primary_10_1016_j_rcot_2018_05_010 crossref_primary_10_1016_j_otsr_2018_02_017 crossref_primary_10_1016_j_semss_2025_101167 crossref_primary_10_1007_s00586_022_07408_3 crossref_primary_10_22603_ssrr_2024_0285 crossref_primary_10_1177_2192568218772302 crossref_primary_10_1016_j_rcot_2023_01_003 crossref_primary_10_1016_j_wneu_2023_06_047 crossref_primary_10_1186_s12891_019_3028_8 crossref_primary_10_1016_j_wneu_2019_04_105 |
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| Keywords | Spondylolisthesis Arthrodesis Reduction Lumbar spine Low-grade In situ |
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| Snippet | Purpose
To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis.
Methods
We... To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis. We performed a... Purpose To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis. Methods We... To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis.PURPOSETo compare the... To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis. We performed a... |
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| SubjectTerms | Blood Loss, Surgical Humans Medicine Medicine & Public Health Neurosurgery Operative Time Review Article Spinal Fusion Spondylolisthesis - surgery Surgical Orthopedics Visual Analog Scale |
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| Title | Is reduction better than arthrodesis in situ in surgical management of low-grade spondylolisthesis? A system review and meta analysis |
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