A meta-analysis of short fusion versus long fusion for degenerative scoliosis

doi:10.3969/j.issn.2095-4344.2016.13.020

Abstract

Abstract:

BACKGROUND: At present, the main purpose of treatment for degenerative scoliosis is to relieve symptoms, surgically correct scoliosis, restore balance and function of the spine, but what kind of techniques is superior has been controversial.

OBJECTIVE: To systematically assess the clinical effectiveness and safety of short fusion versus long fusion for degenerative scoliosis.

METHODS: The databases such as China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journals Database, WanFang Database, The Cochrane Library, PubMed, and EMbase published before May 2015 were electronically searched to collect the trials about the short fusion versus long fusion for degenerative scoliosis. Meta-analysis was performed by using RevMan 5.3.4 software.

RESULTS AND CONCLUSION: Eleven studies were included, with 533 patients, including 272 cases in the short fusion group and 261 cases in the long fusion group. Meta-analysis results showed that: compare with short fusion group, long fusion group had better improvement of spine Cobb angle (P < 0.000 01) and lordosis angle (P < 0.000 01). No differences were found in the coronal imbalance (P=0.06) and lateral slippage (P=0.24) between the two groups. No significant difference was detected in Japanese Orthopaedic Association score (P=0.93), Visual analogue scale score (P=0.22), and Oswestry Disability Index score (P=0.13) between the two groups. The postoperative complications (P=0.000 6) and the rate of reoperation (P=0.03) were higher in the long fusion group than those in the short fusion group. The incidence of adjacent segment disease has no difference between the two groups (P=0.81). These findings suggest that long fusion is better than short fusion in improvement of the deformity of spine, but incidence of postoperative complications and the rate of reoperation are higher than those in the short fusion group. Comprehensive consideration should be given to the selection of a fixed fusion scheme.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Lu Hai-tao, Yuan Feng, Yang Yu-ming, Zhang Jun-wei, Li Zhi-duo, Sheng Xiao-lei. A meta-analysis of short fusion versus long fusion for degenerative scoliosis[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(13): 1970-1976.

Figures/Tables 6

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