1. Abstract # 37553
Rates of Complications and Required Additional Surgical Interventions after Surgical and Nonsurgical Treatment in Lumbar Spondylosis: A Systematic Review with Meta Analysis
Andriy Noshchenko PhD, Emily M. Lindley PhD,
Evalina L. Burger MD, Christopher M.J. Cain MD,
Vikas V. Patel MD

2. The purpose of this study
Evaluate and compare:
1. long term complication rate;
2. rate of additional surgical treatment;
after surgical and nonsurgical treatment in lumbar spondylosis
Surgical treatment included:
arthrodesis,
decompression without arthrodesis
arthroplasty

3. Methods
Comprehensive literature search: MEDLINE, EMBASE and the Cochrane Library
Selection of publications (randomized controlled clinical trials)
Quality assessment of included studies (Cochrane Back Review Group scale)
Data extraction (complication and additional surgical treatment rates)
Meta analysis of the combined data (inverse variance method, random effect modeling)
Level of evidence assessment (GRADE)

4. Results: Literature search
Of 1411 total citations, 26 RCTs of 4949 participants were included in the review and meta analysis [1-26]
Selected studies had moderate quality, with scores ranging from 6-9 (out of 12) on the Cochrane Back Review Group scale

5. Results: Pooled outcomes

6. Results: Comparative meta analysis
FAVORABLE FOR COMPARED TREATMENT
FAVORABLE FOR LUMBAR FUSION

7. Conclusions/Level of evidence
Level of evidence (GRADE)
Conclusions
High
Lumbar arthrodesis was associated with higher complication rate than lumbar arthroplasty at 2 years postoperative due to pseudarthrosis, autograft donor site pain, and loss of disc height typical for this intervention
Moderate
However, the rate of additional surgery was not significantly different between lumbar arthrodesis, lumbar arthroplasty, and decompression without fusion
The rate of surgical treatment 2-4 years after conservative treatment was significantly higher then that after lumbar arthrodesis

8. THANK YOU