Abstract
The first line of treatment for lumbar spinal stenosis (with or without lumbar degenerative spondylolisthesis) involves conservative options such as anti-inflammatory drugs and analgesics. Approximately, 10%-15% of patients require surgery. Surgical treatment aims to decompress the spinal canal and dural sac from degenerative bony and ligamentous overgrowth. Different studies have given conflicting results. The aim of our study is to clear the confusion by comparing two surgical techniques. This meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A literature search was conducted of the Ovid Embase, Scopus, Pubmed, Ovid Medline, Google Scholar, and Cochrane library databases. A quality and risk of bias assessment was also done. The analysis was done using Revman software (The Nordic Cochrane Centre, The Cochrane Collaboration, 2014, Copenhagen, Denmark).A total of 76 studies were extracted from the literature search and 29 studies with relevant information were shortlisted. Nine studies were included in the meta-analysis after a quality assessment and eligibility. Fusion with decompression surgery was found to be a better technique when compared to decompression alone for spinal stenosis in terms of the Oswestry Disability index and the visual analog pain scale for back and leg pain. On the basis of the meta-analysis of the recent medical literature, the authors concluded that decompression with fusion is a 3.5-times better surgical technique than decompression alone for spinal stenosis.
Highlights
BackgroundLumbar spinal stenosis (LSS) is defined as the narrowing of the lumbar spinal canal and nerve root canals due to hypertrophic lesions of the facet joints, ligamentum flavum, and inter-vertebral discs, which leads to a debilitating compression of the spinal nerves and blood vessels [1,2]
On the basis of the meta-analysis of the recent medical literature, the authors concluded that decompression with fusion is a 3.5-times better surgical technique than decompression alone for spinal stenosis
A detailed literature search was conducted by two independent authors using the keywords “spinal fusion surgery,” “spinal decompression surgery,” “spinal stenosis,” “Oswestry Disability index,” and “degenerative spondylolisthesis” to search the Ovid Embase, Scopus, Pubmed, Ovid Medline, Google Scholar and Cochrane library databases
Summary
Lumbar spinal stenosis (LSS) is defined as the narrowing of the lumbar spinal canal and nerve root canals due to hypertrophic lesions of the facet joints, ligamentum flavum, and inter-vertebral discs, which leads to a debilitating compression of the spinal nerves and blood vessels [1,2]. It is one of the most prevalent spinal disorders in the elderly. LSS often occurs in combination with lumbar degenerative spondylolisthesis (LDS), which, in turn, is defined as the slipping forward of one lumbar vertebra on another with an intact neural arch [4]. The immobilization of one or more motion segments by fusion techniques involves joining two or more vertebrae permanently into one solid bone with no space between them [9]
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