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Review
. 2022 Feb 21;17(1):116.
doi: 10.1186/s13018-022-03015-6.

Effects of posterior lumbar nonfusion surgery with isobar devices versus posterior lumbar interbody fusion surgery on clinical and radiological features in patients with lumbar degenerative diseases: a meta-analysis

Jianbin Guan  1 , Tao Liu  1 , Wenhao Li  1 , He Zhao  1 , Kaitan Yang  1 , Chuanhong Li  1 , Ningning Feng  1 , Guozheng Jiang  1 , Yongdong Yang  1 , Xing Yu  2
Affiliations
Review

Effects of posterior lumbar nonfusion surgery with isobar devices versus posterior lumbar interbody fusion surgery on clinical and radiological features in patients with lumbar degenerative diseases: a meta-analysis

Jianbin Guan et al. J Orthop Surg Res. .

Abstract

Purpose: The aim of this study was to systematically evaluate the efficacy of posterior lumbar isobar nonfusion with isobar devices versus posterior lumbar interbody fusion (PLIF) in the treatment of patients with lumbar degenerative diseases (LDDs).

Materials and method: We performed a literature review and meta-analysis in accordance with the Cochrane methodology. The analysis included a Group Reading Assessment and Diagnostic Evaluation assessments, Jadad Quality Score evaluations, and Risk of Bias in Randomized Studies of Interventions assessments. The PubMed, Ovid, EMBASE, Web of Science, MEDLINE, CNKI, VIP and WanFang databases were searched to collect and compare relevant randomized controlled trials and cohort studies of isobar nonfusion and PLIF in the treatment of lumbar degenerative diseases. The retrieval time was from database inception to June 2021. Two evaluators independently screened the literature, extracted data, and evaluated the quality of the included studies. Outcome measures of interest included low back pain, disability, and radiological features. The protocol for this systematic review was registered on INPLASY (2021110059) and is available in full on inplasy.com ( https://inplasy.com/inplasy-2021-11-0059/ ).

Results: Of the 7 RCTs, 394 patients met the inclusion criteria. The meta-analysis results showed that isobar nonfusion surgery shortened the surgical duration (P = 0.03), reducing intraoperative bleeding (P = 0.001), retained the ROM of surgical segment (P < 0.00001) and the ROM of the lumbar spine (P < 0.00001), and reduced the incidence of ASD (P = 0.0001). However, no significant difference in the postoperative ODI index (P = 0.81), VAS score of LBP (P = 0.59, VAS score of lower limb pain (P = 0.05, and JOA score (P = 0.27) was noted.

Conclusions: Posterior lumbar nonfusion surgery with isobar devices is superior to PLIF in shortening the surgical duration, reducing intraoperative bleeding, retaining the ROM of surgical segments and the lumbar spine to a certain extent, and preventing ASD. Given the possible publication bias, we recommend further large-scale studies.

Keywords: Isobar device; Lumbar nonfusion surgery; Meta-analysis; Posterior lumbar interbody fusion.

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Conflict of interest statement

The authors declare that they have no competing interests in this section.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process
Fig. 2
Fig. 2
Risk of bias summary. Plus sign indicates low risk of bias. Minus sign indicates high risk of bias, and question mark bias unclear
Fig. 3
Fig. 3
Forest plot of comparison: surgical duration between isobar nonfusion and PLIF
Fig. 4
Fig. 4
Forest plot of comparison: intraoperative bleeding between isobar nonfusion and PLIF
Fig. 5
Fig. 5
Forest plot of comparison: ODI scores between isobar nonfusion and PLIF
Fig. 6
Fig. 6
Forest plot of comparison: VAS scores for LBP between isobar nonfusion and PLIF
Fig. 7
Fig. 7
Forest plot of comparison: VAS scores for lower limb pain between isobar nonfusion and PLIF
Fig. 8
Fig. 8
Forest plot of comparison: JOA scores between isobar nonfusion and PLIF
Fig. 9
Fig. 9
Forest plot of comparison: the changes of surgical segment ROM between ISOBAR NONFUSION and PLIF
Fig. 10
Fig. 10
Forest plot of comparison: the changes of lumbar ROM between isobar nonfusion and PLIF
Fig. 11
Fig. 11
Forest plot of comparison: the incidence of ASD case between isobar nonfusion and PLIF
Fig. 12
Fig. 12
Funnel plot to detect publication bias for the studies
See this image and copyright information in PMC

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References

    1. Huang RC, Girardi FP, Lim MR, et al. Advantages and disadvantages of nonfusion technology in spine surgery. Orthop Clin N Am. 2005;36(3):263–269. doi: 10.1016/j.ocl.2005.02.006. - DOI - PubMed
    1. Lee SE, Park SB, Jahng TA, et al. Clinical experience of the dynamic stabilization system for the degenerative spine disease. J Korean Neurosurg Soc. 2008 doi: 10.3340/jkns.2008.43.5.221. - DOI - PMC - PubMed
    1. Chou D, Lau D, Skelly A, et al. Dynamic stabilization versus fusion for treatment of degenerative spine conditions. Evid Based Spine Care J. 2011;2(3):33–42. doi: 10.1055/s-0030-1267111. - DOI - PMC - PubMed
    1. Shu-Fen S, Meng-Shan W, Wen-Ting Y, et al. Effects of lumbar fusion surgery with ISOBAR devices versus posterior lumbar interbody fusion surgery on pain and disability in patients with lumbar degenerative diseases: a meta-analysis. J Invest Surg. 2018 doi: 10.1080/08941939.2018.1472318. - DOI - PubMed
    1. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. Open Med. 2009, 3(3):e123–30. 10.1016/j.jclinepi.2009.06.005 - PMC - PubMed

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