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Objective To analyze the effectiveness of laminectomy decompression compared with vertebral lamina decompression combined with lumbar fusion in Degree I spondylolisthesis and spinal canal stenosis. Methods PubMed, Science Direct Online, Springer, CNKI, Wan Fang and VIP were retrieved to collect relevant randomized controlled trials( RCT) . According to inclusion and exclusion criteria,two researchers screened literatures, extracted data and evaluated quality. RevMan5. 0 software was used for Meta analysis. A total of 11 RCT were included,with a total of 1684 patients. Meta analysis showed that compared with the simple laminectomy group,the VAS score of lumbar pain in the lumbar fusion group at 1 years after operation decreased ( MD and 95％CI:-1. 20(-1. 57--0. 83) ,P<0. 05) ,and the VAS score of the 1 year postoperative leg pain in the lumbar fusion group decreased(MD and 95％CI:-0. 88(-1. 32- -0. 44),P<0. 05),the excellent rate of lumbar fusion group at 2 years after operation was higher( OR and 95％CI:1. 65( 1. 13-2. 41) ,P<0. 05) . There was no significant difference in postoperative complications and lumbar spondylolisthesis at 1 years after operation. Conclusion In long term, compared with decompression alone, vertebral lamina decompression combined with lumbar fusion has more ideal effectiveness in the treatment.
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Objective To study the influence of spinal instability after lamina decompression in symptoms and progno?sis. Methods The 76 patients were followed up for a minimum of 4 more years. The patients were divided into instability group (n=27) and non-instability (n=49) group according to the X-ray result of the final follow-up. The visual analogue scale (VAS) score, JOA score and improvement rate were compared between two groups at preoperation, 3-month after operation and the final follow-up. Results There were no significant differences in gender, age and mean follow-up time between two groups. There were no significant differences in VAS and JOA scores before surgery, 3-month after surgery and final follow-up between two groups. Postoperative VAS score decreased and JOA score increased with the increase in follow-up time (P 0.05). Conclusion Although some patients show instability even with lumbar spondylolisthesis after lamina decompression on radiograph,which is no correlation with improvement of symptoms. With appropriate indications, lamina decompression is a simple and effective surgical method,which also retains the spinal movement function.