Corluka Stipe, Muthu Sathish, Yoon Tim, Cunha Carla, Gary Matthew, Vadala Gianluca, Barbanto Brodano Giovanni, Monetta Annalisa, Demetriades Andreas, Ivandić Stjepan, Wu Yabin, Wang Jeffrey, Meisel Hans-Jorg, Buser Zorica
Spinal Surgery Division, Department of Traumatology, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia.
St. Catherine Specialty Hospital, Zagreb, Croatia.
Global Spine J. 2025 May 14:21925682251342230. doi: 10.1177/21925682251342230.
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.
系统评价。
当前文献表明，单纯减压手术可能是治疗低度退行性腰椎滑脱的一种合适选择。有必要了解未能充分选择患者以取得可接受结果的原因。我们的目的是确定与退行性腰椎滑脱单纯减压手术失败相关的因素。
按照系统评价和荟萃分析的首选报告（PRISMA）指南，对科学数据库（PubMed、Scopus、clinicaltrials.gov、Web of Science）进行独立的系统评价，以识别相关文章。纳入分析退行性腰椎滑脱单纯减压手术后失败危险因素的研究。使用Stata软件进行汇总分析。
纳入了六项研究，包括成功组和失败组的基线特征。个体研究分析发现，如责任节段活动度和多节段减压等因素是导致失败的原因。然而，汇总分析显示，两组之间的患者相关因素（年龄、性别、体重指数）、疾病相关因素（Pfirrmann分级、滑脱距离、椎间盘高度、小关节角度、移位、责任节段活动度、骶骨倾斜度）和结局参数（视觉模拟评分法、Oswestry功能障碍指数和日本骨科学会评分）均无显著差异。
分析退行性腰椎滑脱单纯减压手术失败危险因素的高质量证据有限。尽管在个体研究中发现责任节段活动度和多节段减压等因素是潜在危险因素，但汇总分析未发现其中任何一个因素能显著预测退行性腰椎滑脱单纯减压手术的失败。
