Scolaris Content Display Scolaris Content Display

Comparison 1 DECOMPRESSION vs CONSERVATIVE, Outcome 1 Secondary surgery by 4 years.
Figures and Tables -
Analysis 1.1

Comparison 1 DECOMPRESSION vs CONSERVATIVE, Outcome 1 Secondary surgery by 4 years.

Comparison 1 DECOMPRESSION vs CONSERVATIVE, Outcome 2 Bad result at 10 years.
Figures and Tables -
Analysis 1.2

Comparison 1 DECOMPRESSION vs CONSERVATIVE, Outcome 2 Bad result at 10 years.

Comparison 2 MULTIPLE LAMINOTOMY vs LAMINECTOMY, Outcome 1 No success: combined patient / surgeon rating.
Figures and Tables -
Analysis 2.1

Comparison 2 MULTIPLE LAMINOTOMY vs LAMINECTOMY, Outcome 1 No success: combined patient / surgeon rating.

Comparison 2 MULTIPLE LAMINOTOMY vs LAMINECTOMY, Outcome 2 Spondylolisthesis progression.
Figures and Tables -
Analysis 2.2

Comparison 2 MULTIPLE LAMINOTOMY vs LAMINECTOMY, Outcome 2 Spondylolisthesis progression.

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 1 Poor result 18‐24 months ‐ Surgeon rating.
Figures and Tables -
Analysis 3.1

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 1 Poor result 18‐24 months ‐ Surgeon rating.

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 2 Re‐operation 2‐4 years.
Figures and Tables -
Analysis 3.2

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 2 Re‐operation 2‐4 years.

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 3 Spondylolisthesis progression.
Figures and Tables -
Analysis 3.3

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 3 Spondylolisthesis progression.

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 4 No improvement in walking distance.
Figures and Tables -
Analysis 3.4

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 4 No improvement in walking distance.

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 5 Good result at 18‐24 months.
Figures and Tables -
Analysis 3.5

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 5 Good result at 18‐24 months.

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 6 No spondylolisthesis progression.
Figures and Tables -
Analysis 3.6

Comparison 3 LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY, Outcome 6 No spondylolisthesis progression.

Comparison 4 LAMINECTOMY PLUS MULTI‐LEVEL FUSION vs LAMINECTOMY, Outcome 1 Poor result as rated by patient ‐ at 2yrs.
Figures and Tables -
Analysis 4.1

Comparison 4 LAMINECTOMY PLUS MULTI‐LEVEL FUSION vs LAMINECTOMY, Outcome 1 Poor result as rated by patient ‐ at 2yrs.

Comparison 4 LAMINECTOMY PLUS MULTI‐LEVEL FUSION vs LAMINECTOMY, Outcome 2 Poor result as rated by independent assessor ‐ at 2yrs.
Figures and Tables -
Analysis 4.2

Comparison 4 LAMINECTOMY PLUS MULTI‐LEVEL FUSION vs LAMINECTOMY, Outcome 2 Poor result as rated by independent assessor ‐ at 2yrs.

Comparison 4 LAMINECTOMY PLUS MULTI‐LEVEL FUSION vs LAMINECTOMY, Outcome 3 Re‐operation by 28mths.
Figures and Tables -
Analysis 4.3

Comparison 4 LAMINECTOMY PLUS MULTI‐LEVEL FUSION vs LAMINECTOMY, Outcome 3 Re‐operation by 28mths.

Comparison 5 LAMINECTOMY vs NO LAMINECTOMY (Isthmic spondylolisthesis), Outcome 1 No fusion at 4.5yrs.
Figures and Tables -
Analysis 5.1

Comparison 5 LAMINECTOMY vs NO LAMINECTOMY (Isthmic spondylolisthesis), Outcome 1 No fusion at 4.5yrs.

Comparison 5 LAMINECTOMY vs NO LAMINECTOMY (Isthmic spondylolisthesis), Outcome 2 No success ‐ Patient rating at 4.5yrs.
Figures and Tables -
Analysis 5.2

Comparison 5 LAMINECTOMY vs NO LAMINECTOMY (Isthmic spondylolisthesis), Outcome 2 No success ‐ Patient rating at 4.5yrs.

Comparison 6 LAMINECTOMY PLUS ONE LEVEL FUSION (No instrumentation, spinal stenosis + degen spondylolisthesis vs LAMINECT, Outcome 1 Poor result as rated by surgeon ‐ at 36 mths (ave).
Figures and Tables -
Analysis 6.1

Comparison 6 LAMINECTOMY PLUS ONE LEVEL FUSION (No instrumentation, spinal stenosis + degen spondylolisthesis vs LAMINECT, Outcome 1 Poor result as rated by surgeon ‐ at 36 mths (ave).

Comparison 6 LAMINECTOMY PLUS ONE LEVEL FUSION (No instrumentation, spinal stenosis + degen spondylolisthesis vs LAMINECT, Outcome 2 Spondylolisthesis progression at 6 months.
Figures and Tables -
Analysis 6.2

Comparison 6 LAMINECTOMY PLUS ONE LEVEL FUSION (No instrumentation, spinal stenosis + degen spondylolisthesis vs LAMINECT, Outcome 2 Spondylolisthesis progression at 6 months.

Comparison 6 LAMINECTOMY PLUS ONE LEVEL FUSION (No instrumentation, spinal stenosis + degen spondylolisthesis vs LAMINECT, Outcome 3 Re‐operation required within 4 years.
Figures and Tables -
Analysis 6.3

Comparison 6 LAMINECTOMY PLUS ONE LEVEL FUSION (No instrumentation, spinal stenosis + degen spondylolisthesis vs LAMINECT, Outcome 3 Re‐operation required within 4 years.

Comparison 7 LUMBAR FUSION vs CONSERVATIVE (PHYSICAL) THERAPY, Outcome 1 Fair or Poor outcome (independent observer rated).
Figures and Tables -
Analysis 7.1

Comparison 7 LUMBAR FUSION vs CONSERVATIVE (PHYSICAL) THERAPY, Outcome 1 Fair or Poor outcome (independent observer rated).

Comparison 7 LUMBAR FUSION vs CONSERVATIVE (PHYSICAL) THERAPY, Outcome 2 Not back to work at 2 years.
Figures and Tables -
Analysis 7.2

Comparison 7 LUMBAR FUSION vs CONSERVATIVE (PHYSICAL) THERAPY, Outcome 2 Not back to work at 2 years.

Comparison 7 LUMBAR FUSION vs CONSERVATIVE (PHYSICAL) THERAPY, Outcome 3 Unchanged / worse at two years (patient rating).
Figures and Tables -
Analysis 7.3

Comparison 7 LUMBAR FUSION vs CONSERVATIVE (PHYSICAL) THERAPY, Outcome 3 Unchanged / worse at two years (patient rating).

Comparison 8 LUMBAR FUSION vs COGNITIVE EXERCISES (Degenerate disc), Outcome 1 Failure (patient rating) at 1 year.
Figures and Tables -
Analysis 8.1

Comparison 8 LUMBAR FUSION vs COGNITIVE EXERCISES (Degenerate disc), Outcome 1 Failure (patient rating) at 1 year.

Comparison 8 LUMBAR FUSION vs COGNITIVE EXERCISES (Degenerate disc), Outcome 2 Failure (independent assessor) at 1 year.
Figures and Tables -
Analysis 8.2

Comparison 8 LUMBAR FUSION vs COGNITIVE EXERCISES (Degenerate disc), Outcome 2 Failure (independent assessor) at 1 year.

Comparison 9 INSTRUMENTED FUSION vs COGNITIVE EXERCISES (Post discectomy), Outcome 1 Failure (patient rating).
Figures and Tables -
Analysis 9.1

Comparison 9 INSTRUMENTED FUSION vs COGNITIVE EXERCISES (Post discectomy), Outcome 1 Failure (patient rating).

Comparison 9 INSTRUMENTED FUSION vs COGNITIVE EXERCISES (Post discectomy), Outcome 2 Failure (Independent observer rating).
Figures and Tables -
Analysis 9.2

Comparison 9 INSTRUMENTED FUSION vs COGNITIVE EXERCISES (Post discectomy), Outcome 2 Failure (Independent observer rating).

Comparison 10 POSTERO‐LATERAL FUSION +/‐ INSTRUMENTATION vs EXERCISE THERAPY (Isthmic spondylolisthesis), Outcome 1 Sick leave post treatment.
Figures and Tables -
Analysis 10.1

Comparison 10 POSTERO‐LATERAL FUSION +/‐ INSTRUMENTATION vs EXERCISE THERAPY (Isthmic spondylolisthesis), Outcome 1 Sick leave post treatment.

Comparison 10 POSTERO‐LATERAL FUSION +/‐ INSTRUMENTATION vs EXERCISE THERAPY (Isthmic spondylolisthesis), Outcome 2 Failure ‐ patient rating.
Figures and Tables -
Analysis 10.2

Comparison 10 POSTERO‐LATERAL FUSION +/‐ INSTRUMENTATION vs EXERCISE THERAPY (Isthmic spondylolisthesis), Outcome 2 Failure ‐ patient rating.

Comparison 10 POSTERO‐LATERAL FUSION +/‐ INSTRUMENTATION vs EXERCISE THERAPY (Isthmic spondylolisthesis), Outcome 3 Failure ‐ Assessor rating.
Figures and Tables -
Analysis 10.3

Comparison 10 POSTERO‐LATERAL FUSION +/‐ INSTRUMENTATION vs EXERCISE THERAPY (Isthmic spondylolisthesis), Outcome 3 Failure ‐ Assessor rating.

Comparison 11 INSTRUMENTED FUSION vs LAMINECTOMY (mixed, single/multi‐level), Outcome 1 Poor result as rated by patient ‐ at >2yrs.
Figures and Tables -
Analysis 11.1

Comparison 11 INSTRUMENTED FUSION vs LAMINECTOMY (mixed, single/multi‐level), Outcome 1 Poor result as rated by patient ‐ at >2yrs.

Comparison 11 INSTRUMENTED FUSION vs LAMINECTOMY (mixed, single/multi‐level), Outcome 2 Poor result at 2yrs ‐ surgeon rating.
Figures and Tables -
Analysis 11.2

Comparison 11 INSTRUMENTED FUSION vs LAMINECTOMY (mixed, single/multi‐level), Outcome 2 Poor result at 2yrs ‐ surgeon rating.

Comparison 11 INSTRUMENTED FUSION vs LAMINECTOMY (mixed, single/multi‐level), Outcome 3 Re‐operation at 28mths average.
Figures and Tables -
Analysis 11.3

Comparison 11 INSTRUMENTED FUSION vs LAMINECTOMY (mixed, single/multi‐level), Outcome 3 Re‐operation at 28mths average.

Comparison 11 INSTRUMENTED FUSION vs LAMINECTOMY (mixed, single/multi‐level), Outcome 4 Spondylolisthesis progression.
Figures and Tables -
Analysis 11.4

Comparison 11 INSTRUMENTED FUSION vs LAMINECTOMY (mixed, single/multi‐level), Outcome 4 Spondylolisthesis progression.

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 1 Fair/Poor outcome at 1 ‐ 2yr ‐ Surgeon rating.
Figures and Tables -
Analysis 12.1

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 1 Fair/Poor outcome at 1 ‐ 2yr ‐ Surgeon rating.

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 2 2nd procedure by 2yrs.
Figures and Tables -
Analysis 12.2

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 2 2nd procedure by 2yrs.

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 3 No fusion at 2 yrs.
Figures and Tables -
Analysis 12.3

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 3 No fusion at 2 yrs.

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 4 Poor clinical outcome.
Figures and Tables -
Analysis 12.4

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 4 Poor clinical outcome.

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 5 Re‐operation at 5 years.
Figures and Tables -
Analysis 12.5

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 5 Re‐operation at 5 years.

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 6 Pain score at 5 years.
Figures and Tables -
Analysis 12.6

Comparison 12 INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease), Outcome 6 Pain score at 5 years.

Comparison 13 INSTRUMENTED FUSION vs NON‐INSTRUMENTED FUSION (Isthmic spondylolisthesis), Outcome 1 Failure ‐ Patient rating at 2 yr.
Figures and Tables -
Analysis 13.1

Comparison 13 INSTRUMENTED FUSION vs NON‐INSTRUMENTED FUSION (Isthmic spondylolisthesis), Outcome 1 Failure ‐ Patient rating at 2 yr.

Comparison 13 INSTRUMENTED FUSION vs NON‐INSTRUMENTED FUSION (Isthmic spondylolisthesis), Outcome 2 Failure ‐ Assessor rating.
Figures and Tables -
Analysis 13.2

Comparison 13 INSTRUMENTED FUSION vs NON‐INSTRUMENTED FUSION (Isthmic spondylolisthesis), Outcome 2 Failure ‐ Assessor rating.

Comparison 13 INSTRUMENTED FUSION vs NON‐INSTRUMENTED FUSION (Isthmic spondylolisthesis), Outcome 3 Failed fusion (definitely not solid).
Figures and Tables -
Analysis 13.3

Comparison 13 INSTRUMENTED FUSION vs NON‐INSTRUMENTED FUSION (Isthmic spondylolisthesis), Outcome 3 Failed fusion (definitely not solid).

Comparison 14 INTERBODY FUSION + POSTEROLATERAL FUSION vs POSTERLATERAL FUSION, Outcome 1 Fusion failure.
Figures and Tables -
Analysis 14.1

Comparison 14 INTERBODY FUSION + POSTEROLATERAL FUSION vs POSTERLATERAL FUSION, Outcome 1 Fusion failure.

Comparison 14 INTERBODY FUSION + POSTEROLATERAL FUSION vs POSTERLATERAL FUSION, Outcome 2 Complications.
Figures and Tables -
Analysis 14.2

Comparison 14 INTERBODY FUSION + POSTEROLATERAL FUSION vs POSTERLATERAL FUSION, Outcome 2 Complications.

Comparison 14 INTERBODY FUSION + POSTEROLATERAL FUSION vs POSTERLATERAL FUSION, Outcome 3 Not much better.
Figures and Tables -
Analysis 14.3

Comparison 14 INTERBODY FUSION + POSTEROLATERAL FUSION vs POSTERLATERAL FUSION, Outcome 3 Not much better.

Comparison 14 INTERBODY FUSION + POSTEROLATERAL FUSION vs POSTERLATERAL FUSION, Outcome 4 Re‐operation.
Figures and Tables -
Analysis 14.4

Comparison 14 INTERBODY FUSION + POSTEROLATERAL FUSION vs POSTERLATERAL FUSION, Outcome 4 Re‐operation.

Comparison 15 ALIF PLUS POSTEROLATERAL INSTRUMENTED vs ALIF plus INSTRUMENTED, Outcome 1 Fusion failure.
Figures and Tables -
Analysis 15.1

Comparison 15 ALIF PLUS POSTEROLATERAL INSTRUMENTED vs ALIF plus INSTRUMENTED, Outcome 1 Fusion failure.

Comparison 15 ALIF PLUS POSTEROLATERAL INSTRUMENTED vs ALIF plus INSTRUMENTED, Outcome 2 Re‐operation.
Figures and Tables -
Analysis 15.2

Comparison 15 ALIF PLUS POSTEROLATERAL INSTRUMENTED vs ALIF plus INSTRUMENTED, Outcome 2 Re‐operation.

Comparison 16 GRAF LIGAMENTOPLASTY vs ANTERIOR LUMBAR CAGED FUSION, Outcome 1 Re‐operation.
Figures and Tables -
Analysis 16.1

Comparison 16 GRAF LIGAMENTOPLASTY vs ANTERIOR LUMBAR CAGED FUSION, Outcome 1 Re‐operation.

Comparison 17 ANTERIOR THREADED CAGE vs FEMORAL RING FUSION, Outcome 1 Failure of fusion.
Figures and Tables -
Analysis 17.1

Comparison 17 ANTERIOR THREADED CAGE vs FEMORAL RING FUSION, Outcome 1 Failure of fusion.

Comparison 17 ANTERIOR THREADED CAGE vs FEMORAL RING FUSION, Outcome 2 Secondary procedure.
Figures and Tables -
Analysis 17.2

Comparison 17 ANTERIOR THREADED CAGE vs FEMORAL RING FUSION, Outcome 2 Secondary procedure.

Comparison 18 IDET vs SHAM, Outcome 1 No success (observer rated) ‐ at 8 weeks.
Figures and Tables -
Analysis 18.1

Comparison 18 IDET vs SHAM, Outcome 1 No success (observer rated) ‐ at 8 weeks.

Comparison 19 ANY FORM OF ELECTRICAL STIMULATION vs PLACEBO, Outcome 1 Failure of fusion with internal fixation.
Figures and Tables -
Analysis 19.1

Comparison 19 ANY FORM OF ELECTRICAL STIMULATION vs PLACEBO, Outcome 1 Failure of fusion with internal fixation.

Comparison 19 ANY FORM OF ELECTRICAL STIMULATION vs PLACEBO, Outcome 2 Failure of fusion without internal fixation.
Figures and Tables -
Analysis 19.2

Comparison 19 ANY FORM OF ELECTRICAL STIMULATION vs PLACEBO, Outcome 2 Failure of fusion without internal fixation.

Comparison 19 ANY FORM OF ELECTRICAL STIMULATION vs PLACEBO, Outcome 3 Poor clincical outcome.
Figures and Tables -
Analysis 19.3

Comparison 19 ANY FORM OF ELECTRICAL STIMULATION vs PLACEBO, Outcome 3 Poor clincical outcome.

Comparison 20 X‐STOP INTERSPINOUS IMPLANT vs CONTROL, Outcome 1 Secondary surgery.
Figures and Tables -
Analysis 20.1

Comparison 20 X‐STOP INTERSPINOUS IMPLANT vs CONTROL, Outcome 1 Secondary surgery.

Comparison 20 X‐STOP INTERSPINOUS IMPLANT vs CONTROL, Outcome 2 Moderate or severe pain.
Figures and Tables -
Analysis 20.2

Comparison 20 X‐STOP INTERSPINOUS IMPLANT vs CONTROL, Outcome 2 Moderate or severe pain.

Comparison 21 CHARITE DISC REPLACEMENT vs BAK ANTERIOR INTERBODY FUSION, Outcome 1 Oswestry Disability Index at 2 years.
Figures and Tables -
Analysis 21.1

Comparison 21 CHARITE DISC REPLACEMENT vs BAK ANTERIOR INTERBODY FUSION, Outcome 1 Oswestry Disability Index at 2 years.

Comparison 21 CHARITE DISC REPLACEMENT vs BAK ANTERIOR INTERBODY FUSION, Outcome 2 VAS‐pain.
Figures and Tables -
Analysis 21.2

Comparison 21 CHARITE DISC REPLACEMENT vs BAK ANTERIOR INTERBODY FUSION, Outcome 2 VAS‐pain.

Comparison 21 CHARITE DISC REPLACEMENT vs BAK ANTERIOR INTERBODY FUSION, Outcome 3 Device failure.
Figures and Tables -
Analysis 21.3

Comparison 21 CHARITE DISC REPLACEMENT vs BAK ANTERIOR INTERBODY FUSION, Outcome 3 Device failure.

Comparison 1. DECOMPRESSION vs CONSERVATIVE

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Secondary surgery by 4 years Show forest plot

1

30

Odds Ratio (M‐H, Random, 95% CI)

0.09 [0.01, 0.89]

2 Bad result at 10 years Show forest plot

1

19

Odds Ratio (M‐H, Random, 95% CI)

2.43 [0.09, 67.57]

Figures and Tables -
Comparison 1. DECOMPRESSION vs CONSERVATIVE
Comparison 2. MULTIPLE LAMINOTOMY vs LAMINECTOMY

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 No success: combined patient / surgeon rating Show forest plot

1

67

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.25, 2.88]

2 Spondylolisthesis progression Show forest plot

1

67

Odds Ratio (M‐H, Random, 95% CI)

0.56 [0.16, 2.03]

Figures and Tables -
Comparison 2. MULTIPLE LAMINOTOMY vs LAMINECTOMY
Comparison 3. LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Poor result 18‐24 months ‐ Surgeon rating Show forest plot

3

138

Odds Ratio (M‐H, Random, 95% CI)

0.44 [0.13, 1.48]

2 Re‐operation 2‐4 years Show forest plot

2

64

Odds Ratio (M‐H, Random, 95% CI)

4.69 [0.51, 42.83]

3 Spondylolisthesis progression Show forest plot

2

93

Odds Ratio (M‐H, Random, 95% CI)

0.09 [0.00, 2.07]

4 No improvement in walking distance Show forest plot

1

39

Odds Ratio (M‐H, Random, 95% CI)

0.38 [0.06, 2.21]

5 Good result at 18‐24 months Show forest plot

2

93

Odds Ratio (M‐H, Random, 95% CI)

4.41 [1.09, 17.76]

6 No spondylolisthesis progression Show forest plot

2

93

Odds Ratio (M‐H, Random, 95% CI)

11.53 [0.48, 275.52]

Figures and Tables -
Comparison 3. LAMINECTOMY + FUSION ANY TYPE vs LAMINECTOMY
Comparison 4. LAMINECTOMY PLUS MULTI‐LEVEL FUSION vs LAMINECTOMY

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Poor result as rated by patient ‐ at 2yrs Show forest plot

1

30

Odds Ratio (M‐H, Random, 95% CI)

5.74 [0.25, 130.37]

2 Poor result as rated by independent assessor ‐ at 2yrs Show forest plot

1

30

Odds Ratio (M‐H, Random, 95% CI)

8.68 [0.41, 184.28]

3 Re‐operation by 28mths Show forest plot

1

30

Odds Ratio (M‐H, Random, 95% CI)

3.21 [0.12, 85.20]

Figures and Tables -
Comparison 4. LAMINECTOMY PLUS MULTI‐LEVEL FUSION vs LAMINECTOMY
Comparison 5. LAMINECTOMY vs NO LAMINECTOMY (Isthmic spondylolisthesis)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 No fusion at 4.5yrs Show forest plot

1

42

Odds Ratio (M‐H, Random, 95% CI)

15.21 [0.76, 303.32]

2 No success ‐ Patient rating at 4.5yrs Show forest plot

1

42

Odds Ratio (M‐H, Random, 95% CI)

11.5 [1.24, 106.85]

Figures and Tables -
Comparison 5. LAMINECTOMY vs NO LAMINECTOMY (Isthmic spondylolisthesis)
Comparison 6. LAMINECTOMY PLUS ONE LEVEL FUSION (No instrumentation, spinal stenosis + degen spondylolisthesis vs LAMINECT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Poor result as rated by surgeon ‐ at 36 mths (ave) Show forest plot

1

50

Odds Ratio (M‐H, Random, 95% CI)

0.18 [0.01, 4.04]

2 Spondylolisthesis progression at 6 months Show forest plot

1

19

Odds Ratio (M‐H, Random, 95% CI)

4.67 [0.67, 32.36]

3 Re‐operation required within 4 years Show forest plot

1

19

Odds Ratio (M‐H, Random, 95% CI)

3.00 [0.11, 83.36]

Figures and Tables -
Comparison 6. LAMINECTOMY PLUS ONE LEVEL FUSION (No instrumentation, spinal stenosis + degen spondylolisthesis vs LAMINECT
Comparison 7. LUMBAR FUSION vs CONSERVATIVE (PHYSICAL) THERAPY

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Fair or Poor outcome (independent observer rated) Show forest plot

1

262

Odds Ratio (M‐H, Random, 95% CI)

0.26 [0.13, 0.52]

2 Not back to work at 2 years Show forest plot

1

208

Odds Ratio (M‐H, Random, 95% CI)

0.26 [0.10, 0.64]

3 Unchanged / worse at two years (patient rating) Show forest plot

1

257

Odds Ratio (M‐H, Random, 95% CI)

0.28 [0.15, 0.53]

Figures and Tables -
Comparison 7. LUMBAR FUSION vs CONSERVATIVE (PHYSICAL) THERAPY
Comparison 8. LUMBAR FUSION vs COGNITIVE EXERCISES (Degenerate disc)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Failure (patient rating) at 1 year Show forest plot

1

61

Odds Ratio (M‐H, Random, 95% CI)

0.76 [0.25, 2.25]

2 Failure (independent assessor) at 1 year Show forest plot

2

63

Odds Ratio (M‐H, Random, 95% CI)

1.53 [0.48, 4.87]

Figures and Tables -
Comparison 8. LUMBAR FUSION vs COGNITIVE EXERCISES (Degenerate disc)
Comparison 9. INSTRUMENTED FUSION vs COGNITIVE EXERCISES (Post discectomy)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Failure (patient rating) Show forest plot

1

57

Odds Ratio (M‐H, Fixed, 95% CI)

1.07 [0.38, 3.03]

2 Failure (Independent observer rating) Show forest plot

1

57

Odds Ratio (M‐H, Fixed, 95% CI)

1.42 [0.49, 4.08]

Figures and Tables -
Comparison 9. INSTRUMENTED FUSION vs COGNITIVE EXERCISES (Post discectomy)
Comparison 10. POSTERO‐LATERAL FUSION +/‐ INSTRUMENTATION vs EXERCISE THERAPY (Isthmic spondylolisthesis)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Sick leave post treatment Show forest plot

1

106

Odds Ratio (M‐H, Random, 95% CI)

1.06 [0.46, 2.46]

2 Failure ‐ patient rating Show forest plot

1

109

Odds Ratio (M‐H, Random, 95% CI)

0.23 [0.10, 0.53]

3 Failure ‐ Assessor rating Show forest plot

1

109

Odds Ratio (M‐H, Random, 95% CI)

0.09 [0.03, 0.23]

Figures and Tables -
Comparison 10. POSTERO‐LATERAL FUSION +/‐ INSTRUMENTATION vs EXERCISE THERAPY (Isthmic spondylolisthesis)
Comparison 11. INSTRUMENTED FUSION vs LAMINECTOMY (mixed, single/multi‐level)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Poor result as rated by patient ‐ at >2yrs Show forest plot

1

45

Odds Ratio (M‐H, Random, 95% CI)

1.3 [0.22, 7.64]

2 Poor result at 2yrs ‐ surgeon rating Show forest plot

2

113

Odds Ratio (M‐H, Random, 95% CI)

1.96 [0.63, 6.16]

3 Re‐operation at 28mths average Show forest plot

1

45

Odds Ratio (M‐H, Random, 95% CI)

6.69 [0.35, 129.43]

4 Spondylolisthesis progression Show forest plot

1

33

Odds Ratio (M‐H, Random, 95% CI)

0.05 [0.00, 0.60]

Figures and Tables -
Comparison 11. INSTRUMENTED FUSION vs LAMINECTOMY (mixed, single/multi‐level)
Comparison 12. INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Fair/Poor outcome at 1 ‐ 2yr ‐ Surgeon rating Show forest plot

3

193

Odds Ratio (M‐H, Random, 95% CI)

0.58 [0.08, 4.26]

2 2nd procedure by 2yrs Show forest plot

7

494

Odds Ratio (M‐H, Random, 95% CI)

1.05 [0.40, 2.73]

3 No fusion at 2 yrs Show forest plot

8

638

Odds Ratio (M‐H, Random, 95% CI)

0.43 [0.21, 0.91]

4 Poor clinical outcome Show forest plot

8

653

Odds Ratio (M‐H, Random, 95% CI)

0.49 [0.28, 0.84]

5 Re‐operation at 5 years Show forest plot

1

120

Odds Ratio (M‐H, Random, 95% CI)

2.65 [1.08, 6.51]

6 Pain score at 5 years Show forest plot

1

109

Mean Difference (IV, Random, 95% CI)

0.03 [‐1.12, 1.18]

Figures and Tables -
Comparison 12. INSTRUMENTED POSTEROLATERAL FUSION vs GRAFT ONLY (mixed disease)
Comparison 13. INSTRUMENTED FUSION vs NON‐INSTRUMENTED FUSION (Isthmic spondylolisthesis)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Failure ‐ Patient rating at 2 yr Show forest plot

1

75

Odds Ratio (M‐H, Random, 95% CI)

0.37 [0.12, 1.12]

2 Failure ‐ Assessor rating Show forest plot

1

75

Odds Ratio (M‐H, Random, 95% CI)

0.70 [0.25, 1.92]

3 Failed fusion (definitely not solid) Show forest plot

1

74

Odds Ratio (M‐H, Random, 95% CI)

0.51 [0.18, 1.43]

Figures and Tables -
Comparison 13. INSTRUMENTED FUSION vs NON‐INSTRUMENTED FUSION (Isthmic spondylolisthesis)
Comparison 14. INTERBODY FUSION + POSTEROLATERAL FUSION vs POSTERLATERAL FUSION

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Fusion failure Show forest plot

2

201

Odds Ratio (M‐H, Random, 95% CI)

1.08 [0.51, 2.29]

2 Complications Show forest plot

2

201

Odds Ratio (M‐H, Random, 95% CI)

1.00 [0.24, 4.17]

3 Not much better Show forest plot

1

149

Odds Ratio (M‐H, Random, 95% CI)

1.18 [0.59, 2.33]

4 Re‐operation Show forest plot

1

139

Odds Ratio (M‐H, Random, 95% CI)

0.25 [0.09, 0.74]

Figures and Tables -
Comparison 14. INTERBODY FUSION + POSTEROLATERAL FUSION vs POSTERLATERAL FUSION
Comparison 15. ALIF PLUS POSTEROLATERAL INSTRUMENTED vs ALIF plus INSTRUMENTED

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Fusion failure Show forest plot

1

40

Odds Ratio (M‐H, Random, 95% CI)

2.35 [0.40, 13.90]

2 Re‐operation Show forest plot

1

48

Odds Ratio (M‐H, Random, 95% CI)

0.91 [0.28, 2.96]

Figures and Tables -
Comparison 15. ALIF PLUS POSTEROLATERAL INSTRUMENTED vs ALIF plus INSTRUMENTED
Comparison 16. GRAF LIGAMENTOPLASTY vs ANTERIOR LUMBAR CAGED FUSION

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Re‐operation Show forest plot

1

56

Odds Ratio (M‐H, Random, 95% CI)

0.32 [0.01, 8.24]

Figures and Tables -
Comparison 16. GRAF LIGAMENTOPLASTY vs ANTERIOR LUMBAR CAGED FUSION
Comparison 17. ANTERIOR THREADED CAGE vs FEMORAL RING FUSION

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Failure of fusion Show forest plot

1

118

Odds Ratio (M‐H, Fixed, 95% CI)

0.03 [0.01, 0.15]

2 Secondary procedure Show forest plot

1

139

Odds Ratio (M‐H, Fixed, 95% CI)

0.38 [0.18, 0.76]

Figures and Tables -
Comparison 17. ANTERIOR THREADED CAGE vs FEMORAL RING FUSION
Comparison 18. IDET vs SHAM

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 No success (observer rated) ‐ at 8 weeks Show forest plot

1

28

Odds Ratio (M‐H, Random, 95% CI)

1.85 [0.15, 23.07]

Figures and Tables -
Comparison 18. IDET vs SHAM
Comparison 19. ANY FORM OF ELECTRICAL STIMULATION vs PLACEBO

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Failure of fusion with internal fixation Show forest plot

3

290

Odds Ratio (M‐H, Random, 95% CI)

0.59 [0.15, 2.30]

2 Failure of fusion without internal fixation Show forest plot

3

268

Odds Ratio (M‐H, Random, 95% CI)

0.38 [0.22, 0.64]

3 Poor clincical outcome Show forest plot

3

357

Odds Ratio (M‐H, Random, 95% CI)

0.58 [0.27, 1.24]

Figures and Tables -
Comparison 19. ANY FORM OF ELECTRICAL STIMULATION vs PLACEBO
Comparison 20. X‐STOP INTERSPINOUS IMPLANT vs CONTROL

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Secondary surgery Show forest plot

1

196

Odds Ratio (M‐H, Random, 95% CI)

0.26 [0.09, 0.73]

2 Moderate or severe pain Show forest plot

1

167

Odds Ratio (M‐H, Random, 95% CI)

0.14 [0.07, 0.29]

Figures and Tables -
Comparison 20. X‐STOP INTERSPINOUS IMPLANT vs CONTROL
Comparison 21. CHARITE DISC REPLACEMENT vs BAK ANTERIOR INTERBODY FUSION

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Oswestry Disability Index at 2 years Show forest plot

1

258

Mean Difference (IV, Random, 95% CI)

‐4.30 [‐10.28, 1.68]

2 VAS‐pain Show forest plot

1

258

Mean Difference (IV, Random, 95% CI)

‐5.70 [‐13.71, 2.31]

3 Device failure Show forest plot

1

304

Odds Ratio (M‐H, Random, 95% CI)

0.88 [0.32, 2.45]

Figures and Tables -
Comparison 21. CHARITE DISC REPLACEMENT vs BAK ANTERIOR INTERBODY FUSION