Evidence map›Paper›PMID 41476308›Full record

SynthesisJournal of orthopaedic surgery and research2025

Decompression, decompression plus fusion and decompression plus dynamic stabilization for degenerative lumbar spondylolisthesis: a network meta-analysis.

Chen Guo, Fengqi Liu, Haiying Liu, Feng Sun, Shuai Xu

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Chen GuoDepartment of Spinal Surgery, Peking University People's Hospital, Peking University, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China.
Fengqi LiuDepartment of Epidemiology and Health Statistics, School of Public Health, Peking University, No. 38 Xueyuan Road , Haidian District, Beijing, 100871, People's Republic of China.
Haiying LiuDepartment of Spinal Surgery, Peking University People's Hospital, Peking University, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China.
Feng SunDepartment of Epidemiology and Health Statistics, School of Public Health, Peking University, No. 38 Xueyuan Road , Haidian District, Beijing, 100871, People's Republic of China. sunfeng@bjmu.edu.cn.
Shuai XuDepartment of Spinal Surgery, Peking University People's Hospital, Peking University, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China. xushuairmyy@pku.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDegenerative spondylolisthesis (DS) is a common cause of low back pain and lumbar spinal stenosis, necessitating various surgical interventions. Traditional management includes fusion surgery, but recently decompression with or without dynamic stabilization has been explored. However, the relative efficacy and safety of these interventions, including their time-effect relationships, have not been comprehensively evaluated.

objectiveTo systematically assess and compare the effectiveness and safety of decompression alone, decompression plus dynamic stabilization, and decompression plus fusion in patients with low back pain due to DS, and to analyze the time-effect relationship among these interventions over a follow-up period of up to 12 years.

methodsA network meta-analysis was conducted involving 10 studies, including 9 randomized controlled trials, with a total of 1052 participants diagnosed with DS. The interventions compared were decompression alone, decompression plus dynamic stabilization, and decompression plus fusion. Primary outcomes included visual analog scale for low back pain (VAS-LBP), visual analog scale for leg pain (VAS-LP), and Oswestry disability Index (ODI). Secondary outcomes were complications, reoperation rate, operation time, and blood loss. We assessed global inconsistency, risk of bias, and conducted a time-effect analysis using the TE-max model.

resultsThe analysis did not reveal significant global inconsistency or a high risk of bias among the included studies. There were no significant differences between the three interventions regarding changes in VAS-LBP, VAS-LP, and ODI. Decompression alone was associated with significantly shorter operation time (MD = 89.5, 95% CI - 123.91 to - 55.12) and less blood loss (MD = 151.5, 95% CI 37.31 to 265.70) compared to both decompression with fusion and decompression with dynamic stabilization. The time-effect analysis predicted non-inferiority of decompression alone compared to other methods over a follow-up period of up to 12 years.

conclusionsDecompression alone demonstrates non-inferiority in terms of efficacy for treating low back pain due to DS compared to fusion, with additional benefits in operation time and blood loss. The addition of dynamic stabilization to decompression does not yield significant benefits. Further research with larger cohorts and extended follow-up is necessary for definitive conclusions.

Indexed as

Decompression, SurgicalLumbar VertebraeSpinal FusionSpondylolisthesisFemaleHumansLow Back PainNetwork Meta-Analysis as TopicRandomized Controlled Trials as TopicTreatment OutcomeDecompressionDegenerative spondylolisthesisDynamic stabilizationFusionLow back painMeta-analysisTime-effect analysis

Identifiers

PMID41476308
PMCPMC12866522

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.