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Interspinous spacers versus posterior lumbar interbody fusion for degenerative lumbar spinal diseases: a meta-analysis of prospective studies

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Abstract

Purpose

Our aim is to evaluate the safety and effectiveness of interspinous spacers versus posterior lumbar interbody fusion (PLIF) for degenerative lumbar spinal diseases.

Methods

A comprehensive literature search was performed using PubMed, Web of Science and Cochrane Library through September 2015. Included studies were performed according to eligibility criteria. Data of complication rate, post-operative back visual analogue scale (VAS) score, Oswestry Disability Index (ODI) score, estimated blood loss (EBL), operative time, length of hospital stay (LOS), range of motion (ROM) at the surgical, proximal and distal segments were extracted and analyzed.

Results

Ten studies were selected from 177 citations. The pooled data demonstrated the interspinous spacers group had a lower estimated blood loss (weighted mean difference [WMD]: −175.66 ml; 95 % confidence interval [CI], −241.03 to −110.30; p < 0.00001), shorter operative time (WMD: −55.47 min; 95%CI, −74.29 to −36.65; p < 0.00001), larger range of motion (ROM) at the surgical segment (WMD: 3.97 degree; 95%CI, −3.24 to −1.91; p < 0.00001) and more limited ROM at the proximal segment (WMD: −2.58 degree; 95%CI, 2.48 to 5.47; p < 0.00001) after operation. Post-operative back VAS score, ODI score, length of hospital stay, complication rate and ROM at the distal segment showed no difference between the two groups.

Conclusions

Our meta-analysis suggested that interspinous spacers appear to be a safe and effective alternative to PLIF for selective patients with degenerative lumbar spinal diseases. However, more randomized controlled trials (RCT) are still needed to further confirm our results.

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Acknowledgments

Thanks are due to Taifeng Zhou and Chong Chen for valuable discussion.

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Authors and Affiliations

  1. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China

    Yifeng Cai & Hao Yao

  2. Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Jiaquan Luo, Hang Zhou & Peiqiang Su

  3. Department of Orthopaedics, Sun Yat-sen Memorial Hospital, Guangzhou, China

    Junjun Huang & Chengjie Lian

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  1. Yifeng Cai
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  2. Jiaquan Luo
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Correspondence to Peiqiang Su.

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Cai, Y., Luo, J., Huang, J. et al. Interspinous spacers versus posterior lumbar interbody fusion for degenerative lumbar spinal diseases: a meta-analysis of prospective studies. International Orthopaedics (SICOT) 40, 1135–1142 (2016). https://doi.org/10.1007/s00264-016-3139-x

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  • DOI: https://doi.org/10.1007/s00264-016-3139-x

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