Decompression-Only for Lumbar Degenerative Spondylolisthesis - What are the Risk for Failure? - A Systematic Review.

Abstract

Study DesignSystematic review.ObjectiveThe current literature suggests that decompression-only procedures may be an adequate treatment option for low-grade degenerative spondylolisthesis. It is necessary to understand the causes of the failure to adequately select patients to achieve acceptable results. Our aim is to identify factors associated with failure of decompression-only procedures for degenerative lumbar spondylolisthesis.MethodsAn independent systematic review of scientific databases (PubMed, Scopus, clinicaltrials. gov, Web of Science) was performed to identify relevant articles as per the preferred reporting in systematic reviews and meta-analysis (PRISMA) guidelines. Studies analysing the risk factors for failure following decompression-only procedure for degenerative lumbar spondylolisthesis were included. The pooled analysis was performed using the Stata software.ResultsSix studies were included with the baseline characteristics of the successful group and the failed group. Individual study analysis has found factors like motion at index level, and multi-level decompression to be responsible for failure. However, upon pooled analysis patient-related factors (age, sex, BMI), disease-related factors (Pfirrmann grade, slip distance, disc height, facet angulation, translation, movement at index level, sacral slope), and outcome parameters (VAS, ODI and JOA score) between the two groups did not demonstrate any significant difference.ConclusionHigh-quality evidence analysing the risk factors for failure of decompression-only procedure for degenerative spondylolisthesis is limited. Although factors such as motion at index level, and multi-level decompression were found to be potential risk factors in individual studies, pooled analysis did not find any of them to significantly predict failure of decompression-only procedures for degenerative spondylolisthesis.