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Published in: European Spine Journal 6/2019

01-06-2019 | Review

Reoperation of decompression alone or decompression plus fusion surgeries for degenerative lumbar diseases: a systematic review

Authors: Zhao Lang, Jing-Sheng Li, Felix Yang, Yan Yu, Kamran Khan, Louis G. Jenis, Thomas D. Cha, James D. Kang, Guoan Li

Published in: European Spine Journal | Issue 6/2019

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Abstract

Purpose

The objective of this paper was to compare the reoperation rates, timing and causes between decompression alone and decompression plus fusion surgeries for degenerative lumbar diseases through a systematic review of the published data.

Methods

A search of the literature was conducted on PubMed/MEDLINE, EMBASE and the Cochrane Collaboration Library. Reports that included reoperations after decompression alone and/or decompression plus fusion surgeries were selected using designed eligibility criteria. Comparative analysis of reoperation rates, timing and causes between the two surgeries was conducted.

Results

Thirty-two retrospective and three prospective studies were selected from 6401 papers of the literature search. The analysis of data reported in these studies revealed that both surgeries resulted in similar reoperation rates after the primary surgery. However, majority of reoperations following the fusion surgeries were due to adjacent-segment diseases, and following the decompression alone surgeries were due to the same-segment diseases. Reoperation rates were not found to decrease in patients operated more recently than those operated in early times.

Conclusions

Reoperation rates were similar following decompression alone or plus fusion surgeries for degenerative lumbar diseases. However, different underlying major causes exist between the two surgeries. There is no evidence showing that the reoperation rate has a trend to decline with newer surgical techniques used. The exact mechanisms of reoperation after both surgeries are still unclear. Further researches are necessary to investigate the mechanisms of reoperation for improvement of surgical techniques that aim to delay or prevent reoperation after lumbar surgery.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.
Appendix
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Metadata
Title
Reoperation of decompression alone or decompression plus fusion surgeries for degenerative lumbar diseases: a systematic review
Authors
Zhao Lang
Jing-Sheng Li
Felix Yang
Yan Yu
Kamran Khan
Louis G. Jenis
Thomas D. Cha
James D. Kang
Guoan Li
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 6/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-018-5681-2

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