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Abstract title: Rates of Complications and Required Additional Surgical
Interventions after Spinal Arthrodesis versus Alternative Treatment in Lumbar
Spondylosis: A Systematic Review with Meta Analysis
Purpose
The purpose of this study was to 1) evaluate the long-term complication rate (CR)
and rate of additional surgical treatment after lumbar arthrodesis (LA) with or without
decompression for lumbar spondylosis, and 2) compare these outcomes to those of
alternative treatments, including nonsurgical (NST) and disc replacement (TDR).
Methods
This systematic review with meta-analysis included skeletally mature adults with lumbar
DDD included in prior published studies. Selection criteria: RCTs comparing treatment
effects of LA with other interventions for adults with lumbar DDD. Databases searched
included Ovid MEDLINE, Embase, and the Cochrane Library. All years through
February 2013 were included. Complication rate and additional surgical treatment
at 12, 24, or >24 months follow-up was assessed. A meta-analysis was performed.
The GRADE approach was applied for the level of evidence.
Results
Electronic searches provided 1411 citations: 26 RCTs of 4949 participants
were included in the review. The studies investigated 1 or 2 level LA, 1 or 2 level
decompression without arthrodesis, and NST at 12-48 months follow up. The pooled
CR after LA was 25.4% , p