SynthesisNeurosurgical review2025
Comparison between spinal fusion vs. nonoperative treatment for lumbar degenerative pathology: a systematic review and meta-analysis.
Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLumbar fusion is widely used to treat chronic lumbar degenerative pathology; however, its effectiveness and safety compared with nonoperative management remain controversial.
objectivesThis systematic review and meta-analysis aimed to evaluate and compare the effectiveness and safety of spinal fusion and conservative management in treating lumbar degenerative pathology.
methodA systematic review and meta-analysis were conducted following the PRISMA guidelines. The PubMed, Scopus, Cochrane Central, Web of Science, and Embase databases were searched in October 2024. Eligible studies included randomized controlled trials (RCTs) and observational studies reporting pain reduction and functional disability outcomes. The primary outcomes were changes in the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores for back and leg pain. Data were analyzed using a random-effects model in RevMan 5.4.1, with subgroup and sensitivity analyses performed to address heterogeneity.
resultsFourteen studies comprising 13 RCTs and one cohort study, involving 2,399 participants, were included. Spinal fusion showed significant improvements in ODI scores compared to conservative treatment (MD = -6.3; 95% CI [-12.02, -0.57]; p = 0.03), indicating reduced disability. VAS back pain scores also favored spinal fusion (MD = -3.02; 95% CI [-5, 1.04]; p = 0.003), with long-term outcomes showing consistent benefits (MD = -2.26; 95% CI [-3.16, 1.37]; p < 0.00001). However, spinal fusion did not significantly reduce leg pain compared to non-operative options (MD = -2.27; 95% CI [-8.37, 3.83]; p = 0.47).
conclusionSpinal fusion offers statistically significant benefits in reducing disability and back pain compared with conservative treatments for lumbar degenerative pathology. However, it does not confer substantial advantages to leg pain and carries a high surgical risk. These findings emphasize the importance of individualized treatment selection based on patient characteristics and clinical indications.
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Registered trials
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