Sathish Muthu, Stipe Ćorluka, Zorica Buser, James G Malcolm, Zhuojing Luo, Prajwal Gollahalli Shivashankar, Luca Ambrosio, Cristiana Griffoni, Andreas K Demetriades, Stjepan Ivandić, Yabin Wu, Jeffrey Wang, Hans-Jorg Meisel, Tim Sangwook Yoon
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Hence, we aim to identify the failure rates of individual methods of decompression-only procedures performed for degenerative lumbar spondylolisthesis.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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]).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>Level IV. 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引用次数: 0
摘要
背景：采用单纯减压术治疗腰椎退行性滑脱症具有手术时间短、失血量少、住院时间短等优点。然而，根据减压方法的不同，单纯减压术的失败率也不尽相同。因此，我们旨在确定针对退行性腰椎滑脱症的单纯减压术中各种方法的失败率：我们对 4 个科学数据库（PubMed、Scopus、clinicaltrials.gov、Web of Science）进行了独立的系统性回顾，以根据系统性回顾和荟萃分析指南中的首选报告方式确定相关文章。纳入分析的研究报告以退行性腰椎滑脱症单纯减压术后指数水平再次手术的失败率为定义标准。研究使用 Cochrane 的 ROBINS 工具进行评估，并使用 Open Meta[Analyst] 软件进行分析：结果：单纯减压术的总体失败率为 9.1%（95% 置信区间 [CI] [6.5-11.7]）。此外，开放减压术的失败率为 10.9%（95% 置信区间[CI][6.0-15.8]），而显微内窥镜减压术的失败率为 6.7%（95% 置信区间[CI][2.9-10.6]）。失败率从1年的6.9%（95% CI [2.0-11.7]）逐渐增加到2年、3年和5年的7%（95% CI [3.6-10.3]）、11.7%（95% CI [4.5-18.9]）和11.7%（95% CI [6.6-16.7]）。单层减压的失败率为9.6%（95% CI [6.3-12.9]），而多层减压的失败率为8.7%（95% CI [5.6-11.7]）：结论：有关单纯减压术治疗退行性脊椎滑脱症的高质量证据有限。仅减压术的总体失败率为9.1%，减压技术之间无显著差异：证据等级：IV级。有关证据级别的完整描述，请参阅 "作者须知"。
Rate of Reoperation Following Decompression-Only Procedure for Lumbar Degenerative Spondylolisthesis: A Systematic Review of Literature.
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.
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