Cargando…

What Are the Benefits of Lateral Lumbar Interbody Fusion on the Treatment of Adult Spinal Deformity: A Systematic Review and Meta-Analysis Deformity

STUDY DESIGN: A systematic review and meta-analysis OBJECTIVE: The purpose of this systematic review and meta-analysis was to compare the efficacy of lateral lumbar interbody fusion (LLIF) combined with posterior spinal fusion (PSF) with that of conventional PSF in the treatment of adult spinal defo...

Descripción completa

Detalles Bibliográficos
Autores principales: Yang, Honghao, Liu, Jingwei, Hai, Yong, Han, Bo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837508/
https://www.ncbi.nlm.nih.gov/pubmed/35442824
http://dx.doi.org/10.1177/21925682221089876
_version_ 1784869095056867328
author Yang, Honghao
Liu, Jingwei
Hai, Yong
Han, Bo
author_facet Yang, Honghao
Liu, Jingwei
Hai, Yong
Han, Bo
author_sort Yang, Honghao
collection PubMed
description STUDY DESIGN: A systematic review and meta-analysis OBJECTIVE: The purpose of this systematic review and meta-analysis was to compare the efficacy of lateral lumbar interbody fusion (LLIF) combined with posterior spinal fusion (PSF) with that of conventional PSF in the treatment of adult spinal deformity (ASD). METHODS: A comprehensive literature search was performed for relevant studies in PubMed, EMBASE, Web of Science, and the Cochrane Library. Spinopelvic parameters, surgical data, complications, and clinical outcomes at the last follow-up were compared between patients with ASD who underwent LLIF combined with PSF (LLIF+PSF group) and those who underwent conventional PSF (only-PSF group). RESULTS: Ten studies, comprising 621 patients with ASD (313 in the LLIF+PSF group and 308 in the only-PSF group), were included. The level of evidence was III for 7 studies and IV for 3 studies. There was no significant difference in the improvement in the visual analog scale score, systemic complication rate, and revision rate between groups. In the LLIF+PSF group, we noted a superior restoration of lumbar lordosis (weighted mean difference [WMD], 9.77; 95% confidence interval [CI] 7.10 to 12.44, P < .001), pelvic tilt (WMD, −2.50; 95% CI −4.25 to −.75, P = .005), sagittal vertical axis (WMD, −21.92; 95% CI −30.73 to −13.11, P < .001), and C7 plumb line-center sacral vertical line (WMD, −4.03; 95% CI −7.52 to −.54, P = .024); a lower estimated blood loss (WMD, −719.99; 95% CI −1105.02 to −334.96, P < .001) while a prolonged operating time (WMD, 104.89; 95% CI 49.36 to 160.43, P < .001); lower incidence of pseudarthrosis (risk ratio [RR], .26; 95% CI .08 to .79, P = .017) while higher incidence of neurologic deficits (RR, 2.04; 95% CI 1.27 to 3.25, P = .003); and a better improvement in Oswestry Disability Index score (WMD, −7.04; 95% CI −10.155 to −3.93, P < .001) and Scoliosis Research Society-22 total score (WMD, .27; 95% CI .11 to .42, P = .001). The level of evidence in this systematic review and meta-analysis was II. CONCLUSION: Compared with conventional PSF, LLIF combined with PSF was associated with superior restoration of sagittal and coronal alignment, lower incidence of pseudarthrosis, better improvement in quality of life, and less surgical invasiveness in the treatment of ASD, albeit at the cost of prolonged surgical times and substantially high incidence of lower extremity symptoms. Surgeons should weigh the advantages and disadvantages of this procedure, and inform patients about its side effects.
format Online
Article
Text
id pubmed-9837508
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-98375082023-01-14 What Are the Benefits of Lateral Lumbar Interbody Fusion on the Treatment of Adult Spinal Deformity: A Systematic Review and Meta-Analysis Deformity Yang, Honghao Liu, Jingwei Hai, Yong Han, Bo Global Spine J Review Articles STUDY DESIGN: A systematic review and meta-analysis OBJECTIVE: The purpose of this systematic review and meta-analysis was to compare the efficacy of lateral lumbar interbody fusion (LLIF) combined with posterior spinal fusion (PSF) with that of conventional PSF in the treatment of adult spinal deformity (ASD). METHODS: A comprehensive literature search was performed for relevant studies in PubMed, EMBASE, Web of Science, and the Cochrane Library. Spinopelvic parameters, surgical data, complications, and clinical outcomes at the last follow-up were compared between patients with ASD who underwent LLIF combined with PSF (LLIF+PSF group) and those who underwent conventional PSF (only-PSF group). RESULTS: Ten studies, comprising 621 patients with ASD (313 in the LLIF+PSF group and 308 in the only-PSF group), were included. The level of evidence was III for 7 studies and IV for 3 studies. There was no significant difference in the improvement in the visual analog scale score, systemic complication rate, and revision rate between groups. In the LLIF+PSF group, we noted a superior restoration of lumbar lordosis (weighted mean difference [WMD], 9.77; 95% confidence interval [CI] 7.10 to 12.44, P < .001), pelvic tilt (WMD, −2.50; 95% CI −4.25 to −.75, P = .005), sagittal vertical axis (WMD, −21.92; 95% CI −30.73 to −13.11, P < .001), and C7 plumb line-center sacral vertical line (WMD, −4.03; 95% CI −7.52 to −.54, P = .024); a lower estimated blood loss (WMD, −719.99; 95% CI −1105.02 to −334.96, P < .001) while a prolonged operating time (WMD, 104.89; 95% CI 49.36 to 160.43, P < .001); lower incidence of pseudarthrosis (risk ratio [RR], .26; 95% CI .08 to .79, P = .017) while higher incidence of neurologic deficits (RR, 2.04; 95% CI 1.27 to 3.25, P = .003); and a better improvement in Oswestry Disability Index score (WMD, −7.04; 95% CI −10.155 to −3.93, P < .001) and Scoliosis Research Society-22 total score (WMD, .27; 95% CI .11 to .42, P = .001). The level of evidence in this systematic review and meta-analysis was II. CONCLUSION: Compared with conventional PSF, LLIF combined with PSF was associated with superior restoration of sagittal and coronal alignment, lower incidence of pseudarthrosis, better improvement in quality of life, and less surgical invasiveness in the treatment of ASD, albeit at the cost of prolonged surgical times and substantially high incidence of lower extremity symptoms. Surgeons should weigh the advantages and disadvantages of this procedure, and inform patients about its side effects. SAGE Publications 2022-04-20 2023-01 /pmc/articles/PMC9837508/ /pubmed/35442824 http://dx.doi.org/10.1177/21925682221089876 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
Yang, Honghao
Liu, Jingwei
Hai, Yong
Han, Bo
What Are the Benefits of Lateral Lumbar Interbody Fusion on the Treatment of Adult Spinal Deformity: A Systematic Review and Meta-Analysis Deformity
title What Are the Benefits of Lateral Lumbar Interbody Fusion on the Treatment of Adult Spinal Deformity: A Systematic Review and Meta-Analysis Deformity
title_full What Are the Benefits of Lateral Lumbar Interbody Fusion on the Treatment of Adult Spinal Deformity: A Systematic Review and Meta-Analysis Deformity
title_fullStr What Are the Benefits of Lateral Lumbar Interbody Fusion on the Treatment of Adult Spinal Deformity: A Systematic Review and Meta-Analysis Deformity
title_full_unstemmed What Are the Benefits of Lateral Lumbar Interbody Fusion on the Treatment of Adult Spinal Deformity: A Systematic Review and Meta-Analysis Deformity
title_short What Are the Benefits of Lateral Lumbar Interbody Fusion on the Treatment of Adult Spinal Deformity: A Systematic Review and Meta-Analysis Deformity
title_sort what are the benefits of lateral lumbar interbody fusion on the treatment of adult spinal deformity: a systematic review and meta-analysis deformity
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837508/
https://www.ncbi.nlm.nih.gov/pubmed/35442824
http://dx.doi.org/10.1177/21925682221089876
work_keys_str_mv AT yanghonghao whatarethebenefitsoflaterallumbarinterbodyfusiononthetreatmentofadultspinaldeformityasystematicreviewandmetaanalysisdeformity
AT liujingwei whatarethebenefitsoflaterallumbarinterbodyfusiononthetreatmentofadultspinaldeformityasystematicreviewandmetaanalysisdeformity
AT haiyong whatarethebenefitsoflaterallumbarinterbodyfusiononthetreatmentofadultspinaldeformityasystematicreviewandmetaanalysisdeformity
AT hanbo whatarethebenefitsoflaterallumbarinterbodyfusiononthetreatmentofadultspinaldeformityasystematicreviewandmetaanalysisdeformity