[Appropriateness criteria for vertebral arthrodesis]

Martinez Ferez IM, Molina Linde JM, Villegas Portero R
Record ID 32010000797
Authors' recommendations: The available scientific evidence about spinal fusion is scarce and is based on low or moderate quality studies.It has not been found a clear evidence to consider that fusion combined with spinal decompression provides some benefits to the patients who suffer degenerative lumbar stenosis.There is weak evidence in favour of spinal fusion in contrast with decompression for the treatment of degenerative spondylolisthesis, but it is based on studies of low methodological quality.For degenerative discopathies, spinal fusion does not provide clinical benefits if compared with structured and intense conservative treatments with cognitive-behavioural therapy; on the contrary, it seems to provide benefits in contrast with less intensive treatments which are commonly used in practice.For degenerative discopathies with radicular compression, spinal fusion does not seem to provide a clear clinical benefit in contrast with decompression by itself.The total replacement of the degenerated discs by artificial ones like Charité™ and Pro-Disc L shows results at least as good or higher than those obtained by spinal fusion, which is considered the standard treatment in these cases.The total disc replacement by the artificial disc FlexiCore showed good results, but they have to be cautiously treated since they are only preliminary results.Ligamentoplasty as an alternative treatment to spinal fusion for the treatment of degenerative discopathies showed good results. But, as in the case of the FlexiCore disc, they are preliminary outcomes which have to be confirmed.Clinical trials of higher quality are necessary in order to get clear results about the real benefit which fusion provides for the treatment of the spinal degenerative pathologies which have been included in this report.No appropriate indications of arthrodesis have been considered for disc degenerative diseases, 5 appropriate indications for stenosis and 22 for spondylolisthesis.
Project Status: Completed
Year Published: 2009
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Patient Selection
  • Spinal Fusion
Organisation Name: Andalusian Health Technology Assessment Area
Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309
Contact Name: aetsa.csalud@juntadeandalucia.es
Contact Email: aetsa.csalud@juntadeandalucia.es
Copyright: Andalusian Agency for Health Technology Assessment (AETSA)
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