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European Spine Journal

Erschienen in:

10.11.2016 | Review Article

Is reduction better than arthrodesis in situ in surgical management of low-grade spondylolisthesis? A system review and meta analysis

verfasst von: Xuedong Bai, Jiahai Chen, Liyang Liu, Xiaochuan Li, Yaohong Wu, Deli Wang, Dike Ruan

Erschienen in: European Spine Journal | Ausgabe 3/2017

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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.

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Titel: Is reduction better than arthrodesis in situ in surgical management of low-grade spondylolisthesis? A system review and meta analysis
verfasst von: Xuedong Bai
Jiahai Chen
Liyang Liu
Xiaochuan Li
Yaohong Wu
Deli Wang
Dike Ruan
Publikationsdatum: 10.11.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 3/2017
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4810-z

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