Comparison of long-term outcomes of spinal fusion surgeries supplemented with “topping-off” implants in lumbar degenerative diseases: A systematic review and network meta-analysis

Katie Chiou, Yi Chia Chiu, Ching Yu Lee, Tsung Jen Huang, Yi Ching Lai, Chia Ju Yang, Jason C. Hsu, Meng Huang Wu

研究成果: 雜誌貢獻回顧型文獻同行評審

1 引文 斯高帕斯(Scopus)

摘要

Background Context: Spinal fusion surgery is a common treatment for lumbar degenerative diseases and has been associated with the long-term complication of adjacent segment disease (ASD). In recent years, the “topping-off” technique has emerged as a new surgical method, combining spinal fusion with a hybrid stabilization device (HSD) or interspinous process device (IPD) proximal to the fused vertebrae. Methods: A literature search using the PubMed, Cochrane Central Register of Controlled Trials, EMBASE, and Web of Science databases identified eligible studies comparing topping-off implant(s) with spinal fusion surgery for lumbar degenerative diseases. Risk of bias was assessed using the Cochrane RoB 2.0 tool for randomized controlled trials and the Newcastle–Ottawa scale for retrospective studies. Each outcome was analyzed using the statistical Confidence in NMA (CINeMA) 1.9.0 software. Results: 17 RCTs and retrospective studies that included 1255 participants and five interventions were identified. The topping-off implants device for intervertebral assisted motion (DIAM; OR = 0.235, p < 0.001), Dynesys (OR = 0.413, p < 0.001), and Coflex (OR = 0.417, p < 0.01) significantly lowered the incidence of radiographic adjacent segment degeneration (RASDeg) compared with spinal fusion surgery alone. Spinal fusion supplemented with DIAM significantly reduced the incidence of clinical adjacent segment disease (CASD) (OR = 0.358, p = 0.032). Conclusions: Spinal fusion supplemented with DIAM substantially reduced the incidence of radiographic and clinical adjacent segment disease. No significant difference was observed between the treatment comparators for reoperation due to ASD and back pain relief score.
原文英語
文章編號100177
期刊North American Spine Society Journal
12
DOIs
出版狀態已發佈 - 12月 2022

ASJC Scopus subject areas

  • 手術
  • 骨科和運動醫學
  • 神經病學(臨床)

指紋

深入研究「Comparison of long-term outcomes of spinal fusion surgeries supplemented with “topping-off” implants in lumbar degenerative diseases: A systematic review and network meta-analysis」主題。共同形成了獨特的指紋。

引用此