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European Spine Journal

, Volume 25, Issue 5, pp 1522–1532 | Cite as

Adjacent segment degeneration after lumbar spinal fusion compared with motion-preservation procedures: a meta-analysis

  • Aixing Pan
  • Yong Hai
  • Jincai Yang
  • Lijin Zhou
  • Xiaolong Chen
  • Hui Guo
Review Article

Abstract

Purpose

This meta-analysis aimed to evaluate the efficacy of motion-preservation procedures to prevent the adjacent segment degeneration (ASDeg) or adjacent segment disease (ASDis) compared with fusion in lumbar spine.

Methods

PubMed, Embase and the Cochrane Library were comprehensively searched and a meta-analysis was performed of all randomized controlled trials and well designed prospective or retrospective comparative cohort studies assessing the lumbar fusion and motion-preservation procedures. We compared the ASDeg and ASDis rate, reoperation rate, operation time, blood loss, length of hospital stay, visual analogue scale (VAS) and oswestry disability index (ODI) improvement of the two procedures.

Results

A total of 15 studies consisting of 1474 patients were included in this study. The meta-analysis indicated that the prevalence of ASDeg, ASDis and reoperation rate on the adjacent level were lower in motion-preservation procedures group than in the fusion group (P = 0.001; P = 0.0004; P < 0.0001). Moreover, shorter length of hospital stay was found in motion-preservation procedures group (P < 0.0001). No difference was found in terms of operation time (P = 0.57), blood loss (P = 0.27), VAS (P = 0.76) and ODI improvement (P = 0.71) between the two groups.

Conclusions

The present evidences indicated that the motion-preservation procedures had an advantage on reducing the prevalence of ASDeg, ASDis and the reoperation rate due to the adjacent segment degeneration compared with the lumbar fusion. And the clinical outcomes of the two procedures are similar.

Keywords

Adjacent segment degeneration Adjacent segment disease Lumbar spinal fusion Motion-preservation procedures Meta-analysis 

Notes

Compliance with ethical standards

Conflict of interest

None of the authors has any potential conflict of interest. No funds were received in support of this work. No benefits in any form have been or will be received from any commercial party related directly or indirectly to the subject of this manuscript.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Aixing Pan
    • 1
  • Yong Hai
    • 1
  • Jincai Yang
    • 1
  • Lijin Zhou
    • 1
  • Xiaolong Chen
    • 1
  • Hui Guo
    • 1
  1. 1.Department of Orthopedic Surgery, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina

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