• Jie Guo, Yonggang Fan, Han Diao, Jigeng Fan, Jiawei Zhang, Jianwei Li, Donglun Xiao, Runbang Su, Ying Zhang, and Tianwei Sun.
• Graduate School of Tianjin Medical University, Tianjin, China; Department of Spinal Surgery, Tianjin Union Medical Center, Tianjin, China.
• World Neurosurg. 2024 Nov 25.

PurposeAs a common clinical disease, lumbar spinal stenosis (LSS) is currently the preferred surgical treatment, and there are various opinions. We conducted a study on whether fusion should be performed simultaneously with decompression for lumbar spinal stenosis caused by low-grade degenerative lumbar spondylolisthesis and compared the efficacy and safety of the two surgeries.MethodsWe conducted literature searches on Cochrane Library, Embase, PubMed, Scoups, and China National Knowledge Infrastructure databases to search for randomized controlled trials and observational studies that compared decompression alone and decompression plus fusion in the treatment of lumbar spinal stenosis with low-grade lumbar spondylolisthesis. We conducted a meta-analysis on surgical duration, hospital stay, incidence of complications, intraoperative blood loss, lower back and leg pain scores, and Oswestry disability index (ODI) scores.ResultsWe ultimately included 8 articles, including 2 randomized controlled trials and 6 observational studies. Additional fusion did not benefit patients in relieving lower back pain (P=0.05) and leg pain (P=0.12), and there was no significant difference in ODI (P=0.12) and perioperative complication rate (P=0.10) between the two. However, Decompression alone was significantly better than the decompression plus fusion group in terms of surgical time (P=0.0008), hospital stay (P<0.0001), and intraoperative blood loss (P<0.00001).ConclusionsIn this article, decompression alone has shorter surgical and hospitalization time, and less intraoperative bleeding compared to decompression plus fusion. And there was no significant difference in pain score and disability index between the two surgeries during follow-up. Therefore, we can say that for patients with lumbar spinal stenosis caused by low-grade lumbar spondylolisthesis, decompression alone is not inferior to decompression plus fusion.Copyright © 2024. Published by Elsevier Inc.

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