Dataset Information

Comparison of long-term outcomes of spinal fusion surgeries supplemented with "topping-off" implants in lumbar degenerative diseases: A systematic review and network meta-analysis.

ABSTRACT:

Background context

Spinal fusion surgery is a common treatment for lumbar degenerative diseases and has been associated with the long-term complication of adjacent segment disease (ASD). In recent years, the "topping-off" technique has emerged as a new surgical method, combining spinal fusion with a hybrid stabilization device (HSD) or interspinous process device (IPD) proximal to the fused vertebrae.

Methods

A literature search using the PubMed, Cochrane Central Register of Controlled Trials, EMBASE, and Web of Science databases identified eligible studies comparing topping-off implant(s) with spinal fusion surgery for lumbar degenerative diseases. Risk of bias was assessed using the Cochrane RoB 2.0 tool for randomized controlled trials and the Newcastle-Ottawa scale for retrospective studies. Each outcome was analyzed using the statistical Confidence in NMA (CINeMA) 1.9.0 software.

Results

17 RCTs and retrospective studies that included 1255 participants and five interventions were identified. The topping-off implants device for intervertebral assisted motion (DIAM; OR = 0.235, p < 0.001), Dynesys (OR = 0.413, p < 0.001), and Coflex (OR = 0.417, p < 0.01) significantly lowered the incidence of radiographic adjacent segment degeneration (RASDeg) compared with spinal fusion surgery alone. Spinal fusion supplemented with DIAM significantly reduced the incidence of clinical adjacent segment disease (CASD) (OR = 0.358, p = 0.032).

Conclusions

Spinal fusion supplemented with DIAM substantially reduced the incidence of radiographic and clinical adjacent segment disease. No significant difference was observed between the treatment comparators for reoperation due to ASD and back pain relief score.

SUBMITTER: Chiou K

PROVIDER: S-EPMC9650073 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Comparison of long-term outcomes of spinal fusion surgeries supplemented with "topping-off" implants in lumbar degenerative diseases: A systematic review and network meta-analysis.

Chiou Katie K Chiu Yi-Chia YC Lee Ching-Yu CY Huang Tsung-Jen TJ Lai Yi-Ching YC Yang Chia-Ju CJ Hsu Jason C JC Wu Meng-Huang MH

North American Spine Society journal 20221022

<h4>Background context</h4>Spinal fusion surgery is a common treatment for lumbar degenerative diseases and has been associated with the long-term complication of adjacent segment disease (ASD). In recent years, the "topping-off" technique has emerged as a new surgical method, combining spinal fusion with a hybrid stabilization device (HSD) or interspinous process device (IPD) proximal to the fused vertebrae.<h4>Methods</h4>A literature search using the PubMed, Cochrane Central Register of Contr ...[more]

PMID: 36394053

Similar Datasets

Project description:ObjectiveThis study aims to perform a meta-analysis that integrates multiple literature sources to evaluate the clinical efficacy of oblique lumbar interbody fusion (OLIF) versus minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for treating lumbar degenerative diseases (LDD).MethodsA systematic search was conducted across various databases, including CNKI, VIP, WANFANG DATA, SinoMed, PubMed, Cochrane Library, Embase, and Web of Science, for clinical comparative studies on OLIF and MIS-TLIF for treating LDD, covering the time frame from the inception of the databases to September 2024. Following PRISMA guidelines, studies were screened, assessed, and data were extracted rigorously. Indicators extracted included operative time, intraoperative blood loss, hospital stay, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), disc height (DH), segmental lordotic angle (SLA), lumbar lordosis angle (LLA), postoperative JOA scores, patient satisfaction, complication rates, and fusion rates. Meta-analysis was performed using Review Manager 5.4 software.ResultsA total of 24 studies were included, comprising 11 randomized controlled trials and 13 retrospective cohort studies. The total population consisted of 1785 patients, with 898 in the OLIF group and 887 in the MIS-TLIF group. The meta-analysis indicated that, compared to the MIS-TLIF group, the OLIF group exhibited significantly lower intraoperative blood loss, shorter hospital stays, improved postoperative DH, shorter operative time, reduced postoperative VAS scores, lower postoperative ODI scores, and improved postoperative SLA and LLA. No significant differences were observed between the groups in postoperative JOA scores, fusion rates, complication rates, or patient satisfaction. The OLIF group exhibited advantages such as lower blood loss, shorter hospital stays, higher postoperative fusion rates, and improved recovery of disc and foraminal heights.ConclusionCompared to MIS-TLIF, OLIF is associated with a shorter operative time and less intraoperative blood loss, potentially leading to better relief of leg pain, restoration of DH, and prevention of subsidence. These findings offer valuable insights for clinical practice.

Dataset Information

Comparison of long-term outcomes of spinal fusion surgeries supplemented with "topping-off" implants in lumbar degenerative diseases: A systematic review and network meta-analysis.

Background context

Methods

Results

Conclusions

Publications

Comparison of long-term outcomes of spinal fusion surgeries supplemented with "topping-off" implants in lumbar degenerative diseases: A systematic review and network meta-analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets