scholarly journals Postoperative bisphosphonate do not significantly alter the fusion rate after lumbar spinal fusion: a meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jun Mei ◽  
Xiaoxu Song ◽  
Xiaoming Guan ◽  
Dou Wu ◽  
Junjie Wang ◽  
...  
Keyword(s):  
Bone Formation ◽  
Spinal Fusion ◽  
Meta Analysis ◽  
Fusion Rate ◽  
Lumbar Spinal Fusion ◽  
Fusion Surgery ◽  
Number Of Patients ◽  
Cage Subsidence ◽  
Lumbar Spinal

Abstract Background To evaluate the effect of postoperative BP treatment on improving the fusion rate after lumbar spinal fusion surgery by performing a meta-analysis of randomized controlled trials (RCTs) and other comparative cohort studies. Methods A comprehensive search of PubMed, EMBASE, the Web of Science, and the Cochrane Central Register of Controlled Trials was performed for RCTs and other comparative cohort studies on the effect of BP treatment on improving the fusion rate after lumbar spinal fusion surgery. The primary outcome measures were the number of patients with bone formation grades A, B, and C at 12 months of follow-up; fusion rates at 12 and 24 months of follow-up; vertebral compression fracture (VCF) at 12 and 24 months of follow-up; pedicle screw loosening at 24 months of follow-up; and cage subsidence, the Oswestry disability index (ODI), and the visual analogue score (VAS) at 12 months of follow-up. The final search was performed in July 2020. Results Seven studies with 401 patients were included. Compared with the placebo, BP treatment did not significantly alter the number of patients with bone formation grades A, B, and C, or the VAS at the 12-month follow-up or the fusion rates at the 12- and 24-month follow-ups. In addition, compared with the placebo, BPs significantly reduced the risks of VCF at the 12- and 24-month follow-ups, pedicle screw loosening at the 24-month follow-up, and cage subsidence and the ODI at the 12-month follow-up. Conclusions Postoperative BPs do not clearly improve bone formation and the fusion rate, but they reduce VCF, cage subsidence, and loosening of pedicle screws after lumbar fusion surgery compared with the control treatment.

scholarly journals Postoperative Bisphosphonate Do Not Significantly Alter The Fusion Rate After Lumbar Spinal Fusion: A Meta-Analysis

2021 ◽  
Author(s):  
Jun Mei ◽  
Xiaoxu Song ◽  
Xiaoming Guan ◽  
Dou Wu ◽  
Junjie Wang ◽  
...  
Keyword(s):  
Bone Formation ◽  
Spinal Fusion ◽  
Meta Analysis ◽  
Fusion Rate ◽  
Lumbar Spinal Fusion ◽  
Fusion Surgery ◽  
Number Of Patients ◽  
Cage Subsidence ◽  
Lumbar Spinal

Abstract BACKGROUND: To evaluate the effect of postoperative BP treatment on improving the fusion rate after lumbar spinal fusion surgery by performing a meta-analysis of randomized controlled trials (RCTs) and other comparative cohort studies.METHODS: A comprehensive search of PubMed, EMBASE, the Web of Science and the Cochrane Central Register of Controlled Trials was performed for RCTs and other comparative cohort studies on the effect of BP treatment on improving the fusion rate after lumbar spinal fusion surgery. The primary outcome measures were the number of patients with bone formation grades A, B, and C at 12 months of follow-up, fusion rates at 12 and 24 months of follow-up, vertebral compression fracture (VCF) at 12 and 24 months of follow-up, pedicle screw loosening at 24 months follow-up, cage subsidence, the Oswestry Disability Index (ODI) and the visual analogue score (VAS) at 12 months of follow-up. The final search was performed in July 2020.RESULTS: Seven studies with 401 patients were included. Compared with the placebo, BP treatment did not significantly alter the number of patients with bone formation grades A, B and C, or the VAS at the 12-month follow-up or the fusion rates at the 12- and 24-month follow-ups. In addition, compared with the placebo, BPs significantly reduced the risks of VCF at the 12- and 24-month follow-ups, pedicle screw loosening at the 24-month follow-up, and cage subsidence and the ODI at the 12-month follow-up.CONCLUSIONS: Postoperative BPs do not clearly improve bone formation and the fusion rate, but they reduce VCF, cage subsidence and loosening of pedicle screws after lumbar fusion surgery compared with the control treatment.

scholarly journals Fusion or Not for Degenerative Lumbar Spinal Stenosis: A Meta-Analysis and Systematic Review

2018 ◽  
Vol 1 (21;1) ◽  
pp. 1-8
Author(s):  
Jie Hao
Keyword(s):  
Systematic Review ◽  
Spinal Fusion ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Fusion Surgery ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Lumbar Spinal

Background: Degenerative lumbar spinal stenosis (DLSS) is the main cause for chronic low back pain in the elderly. When refractory to conservative treatment, symptomatic patients commonly undergo surgery. However, whether or not fusion is a relatively better surgical option still remains unclear. Objective: The purpose of the present study was to systematically review the clinical outcomes of spinal decompression with or without spinal fusion for DLSS. Study Design: A systematic review of the therapeutic effect for DLSS with or without fusion. Methods: A literature search of 5 electronic databases was performed including PubMed, EMBASE, MEDLINE, Cochrane Library, and CENTRAL from inception to August 2016. Only randomized controlled trials (RCTs) assessing the comparison between decompression and fusion surgery for DLSS were included. Results: A total of 5 RCTs involving 438 patients met the inclusion criteria. Low-quality evidence of the meta-analysis was performed for the heterogeneity of the included studies. Pooled analysis showed no significant differences between decompression alone and fusion groups for the Oswestry Disability Index (ODI) scores at the baseline (P = 0.50) and 2 years follow-up (P = 0.71), and the satisfaction rate of operations was also similar for the groups (P = 0.53). However, operation time (P = 0.002), blood loss (P < 0.00001), and length of hospital stay (P = 0.007) were remarkably higher in the fusion group. Furthermore, there was no difference in the reoperation rate between these 2 groups at the latest follow-up (P = 0.49). Limitation: The methodological criteria and sample sizes were highly variable. The studies were heterogeneous. Conclusion: The present meta-analysis is the first to compare the efficacy of decompression alone and spinal fusion for the treatment of DLSS, including 5 RCTs. Our results demonstrate that additional fusion surgery seems unlikely to result in better outcomes for patients with DLSS, but it may increase additional risks and costs. High-quality homogeneous research is required to provide further evidence about surgical procedures for patients with DLSS. Key words: Decompression, fusion, lumbar spinal stenosis, meta-analysis

Sign in / Sign up

Export Citation Format

Share Document