Adjacent Segment Degeneration after Lumbar Spinal Fusion Compared with Motion-Preservation Procedures: A Meta-analysis

IntroductionAdjacent segment degeneration (ASDeg) or adjacent segment disease (ASDis) is a matter of concern after lumbar fusion. Whether the motion-preservation procedures could reduce the prevalence of ASDeg or ASDis is still controversial. This meta-analysis aimed to evaluate the efficacy of motion-preservation procedures preventing the ASDeg or ASDis compared with fusion in lumbar spine.Methods: PubMed, Embase, the Cochrane Library were comprehensively searched and a meta-analysis was performed of all randomized controlled trials (RCTs) and well designed prospective or retrospective comparative cohort studies assessing the lumbar fusion and motion-preservation procedures. We compared the ASDeg/ASDis rate, reoperation rate, operation time, blood loss, length of hospital stay and VAS/ODI improvement of the two procedures.ResultsA total of 15 studies consisting of 1474 patients were included in this study. The meta-analysis indicated that the prevalence of ASDeg, ASDis and reoperation rate on the adjacen...