AI Article Synopsis
- The study reviews the effectiveness of decompression-only procedures for managing lumbar degenerative spondylolisthesis, highlighting their advantages such as shorter surgery time and minimized blood loss.
- It found an overall failure rate of 9.1%, with open decompression at 10.9% and microendoscopic decompression at 6.7%, suggesting varying outcomes based on the technique used.
- The analysis indicates that failure rates increase over time, peaking at 11.7% by the fifth year, but shows no significant differences between single-level and multilevel decompressions.
Article Abstract
Background: Management of lumbar degenerative spondylolisthesis with decompression-only procedure has been performed for its added benefit of a shorter duration of surgery, lower blood loss, and shorter hospital stay. However, reported failure rates for decompression-only procedures vary depending on the methods utilized for decompression. Hence, we aim to identify the failure rates of individual methods of decompression-only procedures performed for degenerative lumbar spondylolisthesis.
Methods: An independent systematic review of 4 scientific databases (PubMed, Scopus, clinicaltrials.gov, Web of Science) was performed to identify relevant articles as per the preferred reporting in systematic reviews and meta-analysis guidelines. Studies reporting on failure rates defined by reoperation at the index level following decompression-only procedure for degenerative lumbar spondylolisthesis were included for analysis. Studies were appraised using ROBINS tool of Cochrane, and analysis was performed using the Open Meta[Analyst] software.
Results: The overall failure rate of decompression-only procedure was 9.1% (95% confidence interval [CI] [6.5-11.7]). Furthermore, open decompression had failure rate of 10.9% (95% CI [6.0-15.8]), while microendoscopic decompression had failure rate of 6.7% (95% CI [2.9-10.6]). The failure rate gradually increased from 6.9% (95% CI [2.0-11.7]) at 1 year to 7% (95% CI [3.6-10.3]), 11.7% (95% CI [4.5-18.9]), and 11.7% (95% CI [6.6-16.7]) at 2, 3, and 5 years, respectively. Single level decompression had a failure rate of 9.6% (95% CI [6.3-12.9]), while multilevel decompression recorded a failure rate of 8.7% (95% CI [5.6-11.7]).
Conclusion: High-quality evidence on the decompression-only procedure for degenerative spondylolisthesis is limited. The decompression-only procedure had an overall failure rate of 9.1% without significant differences between the decompression techniques.
Level Of Evidence: Level IV. See Instructions for Authors for a complete description of levels of evidence.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221853 | PMC |
| http://dx.doi.org/10.2106/JBJS.OA.23.00163 | DOI Listing |
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