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Total disc replacement versus fusion for lumbar degenerative diseases - a meta-analysis of randomized controlled trials
BACKGROUND: Lumbar fusion is considered to the gold standard for treatment of spinal degenerative diseases but results in adjacent segment degeneration and acquired spinal instability. Total disc replacement is a relatively new alternative avoiding the occurrence of the above complications. The syst...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709089/ https://www.ncbi.nlm.nih.gov/pubmed/31335704 http://dx.doi.org/10.1097/MD.0000000000016460 |
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author | Bai, Deng-yan Liang, Long Zhang, Bing-bing zhu, Tao Zhang, Hai-jun Yuan, Zhi-guo Chen, Yan-fei |
author_facet | Bai, Deng-yan Liang, Long Zhang, Bing-bing zhu, Tao Zhang, Hai-jun Yuan, Zhi-guo Chen, Yan-fei |
author_sort | Bai, Deng-yan |
collection | PubMed |
description | BACKGROUND: Lumbar fusion is considered to the gold standard for treatment of spinal degenerative diseases but results in adjacent segment degeneration and acquired spinal instability. Total disc replacement is a relatively new alternative avoiding the occurrence of the above complications. The systematic review and meta-analysis was designed to evaluate whether total disc replacement exhibited better outcomes and safety. METHODS: PubMed, Web of Science, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure Database(CNKI), Wangfang database, and VIP database were searched for RCTs comparing total disc replacement with lumbar fusion. All statistical analyses were carried out using the RevMan5.3 and STATA12.0 software. RESULTS: Of 1116 citations identified by our search strategy, 14 RCTs met the inclusion criteria. Compared to lumbar fusion, total disc replacement significantly improved ODI, VAS, SF-36, patient satisfaction, overall success, reoperation rate, ODI successful, reduced operation time, shortened duration of hospitalization, decreased postsurgical complications. However, total disc replacement did not show a significant difference regarding blood loss, consumption of analgesics, neurologic success and device success with lumbar fusion. And charges were significantly lower for total disc replacement compared with lumbar fusion in the 1-level patient group, while charges were similar in the 2-level group. CONCLUSION: Total disc replacement is recommended to alleviate the pain of degenerative lumbar diseases, improve the state of lumbar function and the quality of life of patients, provide a high level of security, have better health economics benefits for 1-level patients. |
format | Online Article Text |
id | pubmed-6709089 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-67090892019-10-01 Total disc replacement versus fusion for lumbar degenerative diseases - a meta-analysis of randomized controlled trials Bai, Deng-yan Liang, Long Zhang, Bing-bing zhu, Tao Zhang, Hai-jun Yuan, Zhi-guo Chen, Yan-fei Medicine (Baltimore) Research Article BACKGROUND: Lumbar fusion is considered to the gold standard for treatment of spinal degenerative diseases but results in adjacent segment degeneration and acquired spinal instability. Total disc replacement is a relatively new alternative avoiding the occurrence of the above complications. The systematic review and meta-analysis was designed to evaluate whether total disc replacement exhibited better outcomes and safety. METHODS: PubMed, Web of Science, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure Database(CNKI), Wangfang database, and VIP database were searched for RCTs comparing total disc replacement with lumbar fusion. All statistical analyses were carried out using the RevMan5.3 and STATA12.0 software. RESULTS: Of 1116 citations identified by our search strategy, 14 RCTs met the inclusion criteria. Compared to lumbar fusion, total disc replacement significantly improved ODI, VAS, SF-36, patient satisfaction, overall success, reoperation rate, ODI successful, reduced operation time, shortened duration of hospitalization, decreased postsurgical complications. However, total disc replacement did not show a significant difference regarding blood loss, consumption of analgesics, neurologic success and device success with lumbar fusion. And charges were significantly lower for total disc replacement compared with lumbar fusion in the 1-level patient group, while charges were similar in the 2-level group. CONCLUSION: Total disc replacement is recommended to alleviate the pain of degenerative lumbar diseases, improve the state of lumbar function and the quality of life of patients, provide a high level of security, have better health economics benefits for 1-level patients. Wolters Kluwer Health 2019-07-19 /pmc/articles/PMC6709089/ /pubmed/31335704 http://dx.doi.org/10.1097/MD.0000000000016460 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | Research Article Bai, Deng-yan Liang, Long Zhang, Bing-bing zhu, Tao Zhang, Hai-jun Yuan, Zhi-guo Chen, Yan-fei Total disc replacement versus fusion for lumbar degenerative diseases - a meta-analysis of randomized controlled trials |
title | Total disc replacement versus fusion for lumbar degenerative diseases - a meta-analysis of randomized controlled trials |
title_full | Total disc replacement versus fusion for lumbar degenerative diseases - a meta-analysis of randomized controlled trials |
title_fullStr | Total disc replacement versus fusion for lumbar degenerative diseases - a meta-analysis of randomized controlled trials |
title_full_unstemmed | Total disc replacement versus fusion for lumbar degenerative diseases - a meta-analysis of randomized controlled trials |
title_short | Total disc replacement versus fusion for lumbar degenerative diseases - a meta-analysis of randomized controlled trials |
title_sort | total disc replacement versus fusion for lumbar degenerative diseases - a meta-analysis of randomized controlled trials |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709089/ https://www.ncbi.nlm.nih.gov/pubmed/31335704 http://dx.doi.org/10.1097/MD.0000000000016460 |
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