Purpose:

During surgical procedure on lumbar spondylolisthesis, the role of reducing slip remains controversial. The purpose of this study was to compare fusion in situ with reduction in clinical and radiographic outcomes.

Methods:

A literature research was performed at PubMed, Embase, Web of Science and Cochrane Library. After screened by two authors, 10 articles were brought into this Meta-analysis finally, and the quality was evaluated by the modified Newcastle-Ottawa scale. Isthmic, moderate and serious spondylolisthesis were all analyzed separately. Sensitivity analyses were performed for high quality studies, and the publication bias was evaluated by the funnel plot.

Results:

Most criteria didn’t have statistical differences between reduction and fusion in situ groups. However, in reduction group, the union rate was significantly higher (p=0.008), the slippage was much improved(p<0.001) and the hospital stay was much shorter comparing to no-reduction group (p<0.001). Subgroup analysis (containing moderate and serious slip, or isthmic spondylolisthesis) and sensitivity analysis were all consistent with original ones, and the funnel plot indicated no obvious publication bias in this meta-analysis.

Conclusions:

Both reduction and fusion in situ for lumbar spondylolisthesis were related with good clinical results. Reduction leaded to higher rate of fusion, better radiographic slippage and shorter hospital stay. After sufficient decompression, reduction did not incur additional risk of neurologic impairment compared with fusion in situ.