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Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVESSurgical decompression alone for patients with neurogenic leg pain in the setting of degenerative lumbar scoliosis (DLS) and stenosis is commonly performed, however, there is no summary of evidence for outcomes. METHODS: A systematic searc...

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Autores principales: Echt, Murray, De la Garza Ramos, Rafael, Geng, Eric, Isleem, Ula, Schwarz, Julia, Girdler, Steven, Platt, Andrew, Bakare, Adewale A, Fessler, Richard G, Cho, Samuel K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240589/
https://www.ncbi.nlm.nih.gov/pubmed/36127159
http://dx.doi.org/10.1177/21925682221127955
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author Echt, Murray
De la Garza Ramos, Rafael
Geng, Eric
Isleem, Ula
Schwarz, Julia
Girdler, Steven
Platt, Andrew
Bakare, Adewale A
Fessler, Richard G
Cho, Samuel K
author_facet Echt, Murray
De la Garza Ramos, Rafael
Geng, Eric
Isleem, Ula
Schwarz, Julia
Girdler, Steven
Platt, Andrew
Bakare, Adewale A
Fessler, Richard G
Cho, Samuel K
author_sort Echt, Murray
collection PubMed
description STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVESSurgical decompression alone for patients with neurogenic leg pain in the setting of degenerative lumbar scoliosis (DLS) and stenosis is commonly performed, however, there is no summary of evidence for outcomes. METHODS: A systematic search of English language medical literature databases was performed for studies describing outcomes of decompression alone in DLS, defined as Cobb angle >10˚, and 2-year minimum follow-up. Three outcomes were examined: 1) Cobb angle progression, 2) reoperation rate, and 3) ODI and overall satisfaction. Data were pooled and weighted averages were calculated to summarize available evidence. RESULTS: Across 15 studies included in the final analysis, 586 patients were examined. Average preoperative and postoperative Cobb angles were 17.6˚ (Range: 12.7 - 25˚) and 18.0 (range 14.1 - 25˚), respectively. Average change in Cobb angle was an increase of 1.8˚. Overall rate of reoperation ranged from 3 to 33% with an average of 9.7%. Average ODI before surgery, after surgery, and change in scores were 56.4%, 27.2%, and an improvement of 29% respectively. Average from 8 studies that reported patient satisfaction was 71.2%. CONCLUSIONS: Current literature on decompression alone in the setting of DLS is sparse and is not high quality, limited to patients with small magnitude of lumbar coronal Cobb angle, and heterogenous in the type of procedure performed. Based on available evidence, select patients with DLS who undergo decompression alone had minimal progression of Cobb angle, relatively low reoperation rate, and favorable patient-reported outcomes.
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spelling pubmed-102405892023-06-06 Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis Echt, Murray De la Garza Ramos, Rafael Geng, Eric Isleem, Ula Schwarz, Julia Girdler, Steven Platt, Andrew Bakare, Adewale A Fessler, Richard G Cho, Samuel K Global Spine J Review Articles STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVESSurgical decompression alone for patients with neurogenic leg pain in the setting of degenerative lumbar scoliosis (DLS) and stenosis is commonly performed, however, there is no summary of evidence for outcomes. METHODS: A systematic search of English language medical literature databases was performed for studies describing outcomes of decompression alone in DLS, defined as Cobb angle >10˚, and 2-year minimum follow-up. Three outcomes were examined: 1) Cobb angle progression, 2) reoperation rate, and 3) ODI and overall satisfaction. Data were pooled and weighted averages were calculated to summarize available evidence. RESULTS: Across 15 studies included in the final analysis, 586 patients were examined. Average preoperative and postoperative Cobb angles were 17.6˚ (Range: 12.7 - 25˚) and 18.0 (range 14.1 - 25˚), respectively. Average change in Cobb angle was an increase of 1.8˚. Overall rate of reoperation ranged from 3 to 33% with an average of 9.7%. Average ODI before surgery, after surgery, and change in scores were 56.4%, 27.2%, and an improvement of 29% respectively. Average from 8 studies that reported patient satisfaction was 71.2%. CONCLUSIONS: Current literature on decompression alone in the setting of DLS is sparse and is not high quality, limited to patients with small magnitude of lumbar coronal Cobb angle, and heterogenous in the type of procedure performed. Based on available evidence, select patients with DLS who undergo decompression alone had minimal progression of Cobb angle, relatively low reoperation rate, and favorable patient-reported outcomes. SAGE Publications 2022-09-20 2023-04 /pmc/articles/PMC10240589/ /pubmed/36127159 http://dx.doi.org/10.1177/21925682221127955 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Articles
Echt, Murray
De la Garza Ramos, Rafael
Geng, Eric
Isleem, Ula
Schwarz, Julia
Girdler, Steven
Platt, Andrew
Bakare, Adewale A
Fessler, Richard G
Cho, Samuel K
Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis
title Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis
title_full Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis
title_fullStr Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis
title_full_unstemmed Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis
title_short Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis
title_sort decompression alone in the setting of adult degenerative lumbar scoliosis and stenosis: a systematic review and meta-analysis
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240589/
https://www.ncbi.nlm.nih.gov/pubmed/36127159
http://dx.doi.org/10.1177/21925682221127955
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