Fusion rate and influence of surgery-related factors in lumbar interbody arthrodesis for degenerative spine diseases: a meta-analysis and systematic review

Fusion rate and influence of surgery-related factors in lumbar interbody arthrodesis for degenerative spine diseases: a meta-analysis and systematic review

The aim of this meta-analysis and systematic review is to summarize and critically analyze the influence of surgery-related factors in lumbar interbody fusion for degenerative spine diseases. A systematic review of the literature was carried out with a primary search being performed on Medline throu...

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Bibliographic Details
Published in:Musculoskeletal surgery Vol. 104; no. 1; pp. 1 - 15
Main Authors: Formica, M., Vallerga, D., Zanirato, A., Cavagnaro, L., Basso, M., Divano, S., Mosconi, L., Quarto, E., Siri, G., Felli, L.
Format: Journal Article
Language:English
Published: Milan Springer Milan 01-04-2020
Springer
Springer Nature B.V
Subjects:
Analysis
Back surgery
Degenerative disc disease
Humans
Lumbar Vertebrae - surgery
Medicine
Medicine & Public Health
Meta-analysis
Orthopedics
Review
Spinal Diseases - surgery
Spinal Fusion - methods
Surgery
Surgical Orthopedics
Surgical outcomes
Systematic review
Treatment Outcome
Degenerative lumbar spinal surgery
Outcome
Risk factors
Non-union
Lumbar interbody fusion
Fusion rate
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Summary:The aim of this meta-analysis and systematic review is to summarize and critically analyze the influence of surgery-related factors in lumbar interbody fusion for degenerative spine diseases. A systematic review of the literature was carried out with a primary search being performed on Medline through PubMed. The 2009 PRISMA flowchart and checklist were taken into account. Sixty-seven articles were included in the analysis: 48 studies were level IV of evidence, whereas 19 were level III. All interbody fusion techniques analyzed have proved to reach a good fusion rate. An overall mean fusion rate of 93% (95% CI 92–95%, p  < 0.001) was estimated pooling the selected studies. The influence of sagittal parameters and cages features in fusion rate was not clear. Autograft is considered the gold standard material. The use of synthetic bone substitutes and biological factors alone or combined with bone graft have shown conflicting results. Low level of evidence studies and high heterogeneity ( χ 2  = 271.4, df  = 72, p  < 0.001; I 2  = 73.5%, τ 2  = 0.05) in data analysis could result in the risk of bias. Further high-quality studies would better clarify these results in the future.
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ISSN:2035-5106
2035-5114
DOI:10.1007/s12306-019-00634-x