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Decompression alone versus fusion and Coflex in the treatment of lumbar degenerative disease: A network meta-analysis

BACKGROUND: Lumbar degenerative disease (LDD) is a very common disease. And decompression alone, posterior lumbar interbody fusion (PLIF), and interspinous device (Coflex) are generally accepted surgical techniques. However, the effectiveness and safety of the above techniques are still not clear. N...

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Autores principales: Fan, Yunpeng, Zhu, Liulong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220096/
https://www.ncbi.nlm.nih.gov/pubmed/32176077
http://dx.doi.org/10.1097/MD.0000000000019457
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author Fan, Yunpeng
Zhu, Liulong
author_facet Fan, Yunpeng
Zhu, Liulong
author_sort Fan, Yunpeng
collection PubMed
description BACKGROUND: Lumbar degenerative disease (LDD) is a very common disease. And decompression alone, posterior lumbar interbody fusion (PLIF), and interspinous device (Coflex) are generally accepted surgical techniques. However, the effectiveness and safety of the above techniques are still not clear. Network meta-analysis a comprehensive technique can compare multiple treatments based on indirect dates and all interventions are evaluated and ranked simultaneously. To figure out this problem and offer a better choice for LDD, we performed this network meta-analysis. METHODS: PubMed and WanFang databases were searched based on the following key words, “Coflex,” “decompression,” “PLIF,” “Posterior Lumbar Interbody Fusion,” “Coflex” “Lumbar interbody Fusion.” Then the studies were sorted out on the basis of inclusion criteria and exclusion criteria. A network meta-analysis was performed using The University of Auckland, Auckland city, New Zealand R 3.5.3 software. RESULTS: A total of 10 eligible literatures were finally screened, including 946 patients. All studies were randomized controlled trials (RCTs). Compared with decompression alone group, there were no significant differences of Oswestry Disability Index (ODI) in Coflex and lumbar interbody fusion groups after surgery. However, Coflex and PLIF were better in decreasing Visual Analogue Scale (VAS) score compared with decompression alone. Furthermore, we found Coflex have a less complication incidence rate. CONCLUSION: Compared with decompression alone, Coflex and lumbar interbody fusion had the similar effectiveness in improving lumbar function and quality of life. However, the latter 2 techniques were better in relieving pain. Furthermore, Coflex included a lower complication incidence rate. So we suggested that Coflex technique was a better choice to cue lumbar spinal stenosis (LSS). LEVEL OF EVIDENCE: Systematic review and meta-analysis, level I.
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spelling pubmed-72200962020-06-15 Decompression alone versus fusion and Coflex in the treatment of lumbar degenerative disease: A network meta-analysis Fan, Yunpeng Zhu, Liulong Medicine (Baltimore) 7100 BACKGROUND: Lumbar degenerative disease (LDD) is a very common disease. And decompression alone, posterior lumbar interbody fusion (PLIF), and interspinous device (Coflex) are generally accepted surgical techniques. However, the effectiveness and safety of the above techniques are still not clear. Network meta-analysis a comprehensive technique can compare multiple treatments based on indirect dates and all interventions are evaluated and ranked simultaneously. To figure out this problem and offer a better choice for LDD, we performed this network meta-analysis. METHODS: PubMed and WanFang databases were searched based on the following key words, “Coflex,” “decompression,” “PLIF,” “Posterior Lumbar Interbody Fusion,” “Coflex” “Lumbar interbody Fusion.” Then the studies were sorted out on the basis of inclusion criteria and exclusion criteria. A network meta-analysis was performed using The University of Auckland, Auckland city, New Zealand R 3.5.3 software. RESULTS: A total of 10 eligible literatures were finally screened, including 946 patients. All studies were randomized controlled trials (RCTs). Compared with decompression alone group, there were no significant differences of Oswestry Disability Index (ODI) in Coflex and lumbar interbody fusion groups after surgery. However, Coflex and PLIF were better in decreasing Visual Analogue Scale (VAS) score compared with decompression alone. Furthermore, we found Coflex have a less complication incidence rate. CONCLUSION: Compared with decompression alone, Coflex and lumbar interbody fusion had the similar effectiveness in improving lumbar function and quality of life. However, the latter 2 techniques were better in relieving pain. Furthermore, Coflex included a lower complication incidence rate. So we suggested that Coflex technique was a better choice to cue lumbar spinal stenosis (LSS). LEVEL OF EVIDENCE: Systematic review and meta-analysis, level I. Wolters Kluwer Health 2020-03-13 /pmc/articles/PMC7220096/ /pubmed/32176077 http://dx.doi.org/10.1097/MD.0000000000019457 Text en Copyright © 2020 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 7100
Fan, Yunpeng
Zhu, Liulong
Decompression alone versus fusion and Coflex in the treatment of lumbar degenerative disease: A network meta-analysis
title Decompression alone versus fusion and Coflex in the treatment of lumbar degenerative disease: A network meta-analysis
title_full Decompression alone versus fusion and Coflex in the treatment of lumbar degenerative disease: A network meta-analysis
title_fullStr Decompression alone versus fusion and Coflex in the treatment of lumbar degenerative disease: A network meta-analysis
title_full_unstemmed Decompression alone versus fusion and Coflex in the treatment of lumbar degenerative disease: A network meta-analysis
title_short Decompression alone versus fusion and Coflex in the treatment of lumbar degenerative disease: A network meta-analysis
title_sort decompression alone versus fusion and coflex in the treatment of lumbar degenerative disease: a network meta-analysis
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220096/
https://www.ncbi.nlm.nih.gov/pubmed/32176077
http://dx.doi.org/10.1097/MD.0000000000019457
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