当前位置： SCI文献检索 > SPINE期刊下所有文献 > Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review.

Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review.

Abstract：

STUDY DESIGN:Systematic literature review. OBJECTIVE:To categorize published evidence systematically for lumbar fusion for chronic low back pain (LBP) in order to provide an updated and comprehensive analysis of the clinical outcomes. SUMMARY OF BACKGROUND DATA:Despite a large number of publications of outcomes of spinal fusion surgery for chronic LBP, there is little consensus on efficacy. METHODS:A MEDLINE and Cochrane database search was performed to identify published articles reporting on validated patient-reported clinical outcomes measures (2 or more of visual analogue scale, Oswestry Disability Index, Short Form [36] Health Survey [SF-36] PCS, and patient satisfaction) with minimum 12 months of follow-up after lumbar fusion surgery in adult patients with LBP due to degenerative disc disease. Twenty-six total articles were identified and stratified by level of evidence: 18 level 1 (6 studies of surgery vs. nonoperative treatment, 12 studies of alternative surgical procedures), 2 level 2, 2 level 3, and 4 level 4 (2 prospective, 2 retrospective). Weighted averages of each outcomes measure were computed and compared with established minimal clinically important difference values. RESULTS:Fusion cohorts included a total of 3060 patients. The weighted average improvement in visual analogue scale back pain was 36.8/100 (standard deviation [SD], 14.8); in Oswestry Disability Index 22.2 (SD, 14.1); in SF-36 Physical Component Scale 12.5 (SD, 4.3). Patient satisfaction averaged 71.1% (SD, 5.2%) across studies. Radiographical fusion rates averaged 89.1% (SD, 13.5%), and reoperation rates 12.5% (SD, 12.4%) overall, 9.2% (SD, 7.5%) at the index level. The results of the collective studies did not differ statistically in any of the outcome measures based on level of evidence (analysis of variance, P > 0.05). CONCLUSION:The body of literature supports fusion surgery as a viable treatment option for reducing pain and improving function in patients with chronic LBP refractory to nonsurgical care when a diagnosis of disc degeneration can be made.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Phillips FM,Slosar PJ,Youssef JA,Andersson G,Papatheofanis F

doi

10.1097/BRS.0b013e3182877f11

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

E409-22

issue

eissn

0362-2436

issn

1528-1159

journal_volume

pub_type

杂志文章,评审

在线工具

Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review.