TY - JOUR
T1 - Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis
T2 - A Systematic Review and Meta-Analysis
AU - Echt, Murray
AU - De la Garza Ramos, Rafael
AU - Geng, Eric
AU - Isleem, Ula
AU - Schwarz, Julia
AU - Girdler, Steven
AU - Platt, Andrew
AU - Bakare, Adewale A.
AU - Fessler, Richard G.
AU - Cho, Samuel K.
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2023/4
Y1 - 2023/4
N2 - Study Design: Systematic review and meta-analysis. OBJECTIVESSurgical decompression alone for patients with neurogenic leg pain in the setting of degenerative lumbar scoliosis (DLS) and stenosis is commonly performed, however, there is no summary of evidence for outcomes. Methods: A systematic search of English language medical literature databases was performed for studies describing outcomes of decompression alone in DLS, defined as Cobb angle >10˚, and 2-year minimum follow-up. Three outcomes were examined: 1) Cobb angle progression, 2) reoperation rate, and 3) ODI and overall satisfaction. Data were pooled and weighted averages were calculated to summarize available evidence. Results: Across 15 studies included in the final analysis, 586 patients were examined. Average preoperative and postoperative Cobb angles were 17.6˚ (Range: 12.7 - 25˚) and 18.0 (range 14.1 - 25˚), respectively. Average change in Cobb angle was an increase of 1.8˚. Overall rate of reoperation ranged from 3 to 33% with an average of 9.7%. Average ODI before surgery, after surgery, and change in scores were 56.4%, 27.2%, and an improvement of 29% respectively. Average from 8 studies that reported patient satisfaction was 71.2%. Conclusions: Current literature on decompression alone in the setting of DLS is sparse and is not high quality, limited to patients with small magnitude of lumbar coronal Cobb angle, and heterogenous in the type of procedure performed. Based on available evidence, select patients with DLS who undergo decompression alone had minimal progression of Cobb angle, relatively low reoperation rate, and favorable patient-reported outcomes.
AB - Study Design: Systematic review and meta-analysis. OBJECTIVESSurgical decompression alone for patients with neurogenic leg pain in the setting of degenerative lumbar scoliosis (DLS) and stenosis is commonly performed, however, there is no summary of evidence for outcomes. Methods: A systematic search of English language medical literature databases was performed for studies describing outcomes of decompression alone in DLS, defined as Cobb angle >10˚, and 2-year minimum follow-up. Three outcomes were examined: 1) Cobb angle progression, 2) reoperation rate, and 3) ODI and overall satisfaction. Data were pooled and weighted averages were calculated to summarize available evidence. Results: Across 15 studies included in the final analysis, 586 patients were examined. Average preoperative and postoperative Cobb angles were 17.6˚ (Range: 12.7 - 25˚) and 18.0 (range 14.1 - 25˚), respectively. Average change in Cobb angle was an increase of 1.8˚. Overall rate of reoperation ranged from 3 to 33% with an average of 9.7%. Average ODI before surgery, after surgery, and change in scores were 56.4%, 27.2%, and an improvement of 29% respectively. Average from 8 studies that reported patient satisfaction was 71.2%. Conclusions: Current literature on decompression alone in the setting of DLS is sparse and is not high quality, limited to patients with small magnitude of lumbar coronal Cobb angle, and heterogenous in the type of procedure performed. Based on available evidence, select patients with DLS who undergo decompression alone had minimal progression of Cobb angle, relatively low reoperation rate, and favorable patient-reported outcomes.
KW - decompression
KW - degenerative lumbar scoliosis
KW - laminectomy
KW - radiculopathy
UR - http://www.scopus.com/inward/record.url?scp=85138439128&partnerID=8YFLogxK
U2 - 10.1177/21925682221127955
DO - 10.1177/21925682221127955
M3 - Review article
AN - SCOPUS:85138439128
SN - 2192-5682
VL - 13
SP - 861
EP - 872
JO - Global Spine Journal
JF - Global Spine Journal
IS - 3
ER -