Evidence mapPaperPMID 40857261Full record

SynthesisPloS one2025

Decompression with interbody fusion versus decompression alone for degenerative lumbar diseases: A meta-analysis.

Yuxian Chen, Shenglin Lei, Wei Lin, Yilin Huang, Pinying Cheng, Shuling Gu, Dongping Wang

Abstract readMeta-AnalysisComparative Study
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

7 authors.

Yuxian ChenThe First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Shenglin LeiShenzhen Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Wei LinThe First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Yilin HuangThe Second Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Pinying ChengThe Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Shuling GuAcupuncture Moxibustion and Rehabilitation Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Dongping WangThe First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.ORCID https://orcid.org/0000-0003-4313-8184

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo appraise the clinical effectiveness and complications of two surgical approaches, namely decompression alone (DA) versus decompression with interbody fusion (DF), in managing degenerative lumbar diseases (DLD).

methodsAs of July 1, 2024, an exhaustive search identified all randomized controlled studies and cohort studies comparing DA and DF in DLD management. Relevant data were extracted using strict criteria, and study quality was assessed via the Newcastle-Ottawa Scale and Cochrane Collaboration's tool. The extracted outcomes encompassed a range of measures, including operative duration, intraoperative hemorrhage, hospitalization length, time to ambulation, short form 12 physical component score (SF12-PCS), low back pain visual analog scale (VAS) score, leg pain VAS score, Oswestry disability index (ODI), Japanese orthopedic association (JOA) score, EuroQol five dimensions (EQ-5D), incidence of complications, reoperation rate, and Odom's criteria.

resultsA total of 35 articles were included in this study, involving 12,030 patients. Of these, 7,442 patients were in the DA group, while 4,588 were in the DF group. Operative duration was shorter (MD = -89.09, 95%CI -92.71, -85.47, P < 0.00001), intraoperative hemorrhage was less (MD = -242.26, 95%CI -252.16, -232.36, P < 0.00001), hospitalization length was shorter (MD = -2.36, 95%CI -2.59, -2.14, P < 0.00001), and time to ambulation was reduced (MD = -10.49, 95%CI -12.52, -8.46, P < 0.00001) in the DA group than in the DF group. At the final follow-up for ODI, the DF group demonstrated statistically superior outcomes compared to the DA group (MD = 1.28, 95%CI 0.35, 2.21, P = 0.007). Data revealed no significant differences in SF12-PCS, JOA score, back pain VAS score, leg pain VAS score, final follow-up EQ-5D, reoperation rates, complication rates, and Odom's criteria (P > 0.05).

conclusionWhen treating DLD, DA offers more favorable outcomes in terms of operative duration, intraoperative hemorrhage, hospitalization length, and time to ambulation. These findings suggest that DA should be considered the preferred surgical approach for most DLD patients, unless specific indications for fusion exist. Clinicians should tailor decisions to each surgery's specifics to optimize patient outcomes.

trial registrationPROSPERO registration number: CRD42024580975.

Indexed as

Decompression, SurgicalIntervertebral Disc DegenerationLumbar VertebraeSpinal FusionHumansOperative TimePostoperative ComplicationsRandomized Controlled Trials as TopicTreatment Outcome

Identifiers

PMID40857261
PMCPMC12380314

What Socratic holds

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LicenceCC BY
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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 Socratic graph.