Abstract：
The optimal treatment algorithm for patients with degenerative lumbar spondylolisthesis has not been clarified. Part of the reason for this is that the natural history of degenerative spondylolisthesis (DS) has not been sufficiently studied. Comprehension of the natural history is essential for surgical decision making. We aimed to determine 1) the proportion of patients that develop de novo DS during follow-up; and 2) the proportion of patients with progression of preexistent DS by conducting a systematic review and meta-analysis of the literature.
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Ovid, EMBASE, and the Cochrane Library were searched from their inception through April 2022. Demographic values of the study populations, grade of slip, rate of slippage before and after the follow-up period, and percentage of patients with slip in the populations at baseline and after follow-up were the extracted parameters.
Of the 1909 screened records, eventually 10 studies were included. Of these studies, 5 reported the development of de novo DS and 9 reported on the progression of preexistent DS. Proportions of patients developing de novo DS ranged from 12% to 20% over a period ranging from 4 to 25 years. The proportion of patients with progression of DS ranged from 12% to 34% over a period ranging from 4 to 25 years.
Systematic review and metanalysis of DS on the basis of radiologic parameters revealed both an increasing incidence over time and an increasing progression of the slip rate in up to a third of the patients older than 25 years, which is important for counseling patients and surgical decision making. Importantly, two thirds of patients did not experience slip progression.
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Ovid, EMBASE, and the Cochrane Library were searched from their inception through April 2022. Demographic values of the study populations, grade of slip, rate of slippage before and after the follow-up period, and percentage of patients with slip in the populations at baseline and after follow-up were the extracted parameters.
Of the 1909 screened records, eventually 10 studies were included. Of these studies, 5 reported the development of de novo DS and 9 reported on the progression of preexistent DS. Proportions of patients developing de novo DS ranged from 12% to 20% over a period ranging from 4 to 25 years. The proportion of patients with progression of DS ranged from 12% to 34% over a period ranging from 4 to 25 years.
Systematic review and metanalysis of DS on the basis of radiologic parameters revealed both an increasing incidence over time and an increasing progression of the slip rate in up to a third of the patients older than 25 years, which is important for counseling patients and surgical decision making. Importantly, two thirds of patients did not experience slip progression.
摘要：
目的：退变性腰椎滑脱患者的最佳治疗方法尚未明确。部分原因是DS的自然史尚未得到充分研究。对自然史的理解对于手术决策至关重要。我们旨在通过对文献进行系统回顾和荟萃分析，确定（1）随访期间从头发展DS的患者比例；（2）先前存在的DS进展的患者比例。
方法：本系统综述按照PRISMA指南进行。奥维德,从成立之初到2022年4月，搜索了EMBASE和Cochrane图书馆。研究人群的人口统计值，滑移等级,随访期前后的滑移率，基线和随访后人群中滑倒患者的百分比是提取的参数。
结果：在1909年筛选的记录中，最终纳入10项研究。在这些研究中,5人报告了从头DS的发展，9人报告了先前存在的DS的进展。在4至25年的时间内，从头发展DS的患者比例为12％至20％。在4至25年的时间内，DS进展的患者比例为12％至34％。
结论：基于放射学参数的DS的系统评价和元分析显示，在25年以上的患者中，发病率随着时间的推移而增加，漏诊率也在增加，这对于咨询患者和手术决策非常重要。重要的是,2/3的患者没有经历滑倒进展。
方法：本系统综述按照PRISMA指南进行。奥维德,从成立之初到2022年4月，搜索了EMBASE和Cochrane图书馆。研究人群的人口统计值，滑移等级,随访期前后的滑移率，基线和随访后人群中滑倒患者的百分比是提取的参数。
结果：在1909年筛选的记录中，最终纳入10项研究。在这些研究中,5人报告了从头DS的发展，9人报告了先前存在的DS的进展。在4至25年的时间内，从头发展DS的患者比例为12％至20％。在4至25年的时间内，DS进展的患者比例为12％至34％。
结论：基于放射学参数的DS的系统评价和元分析显示，在25年以上的患者中，发病率随着时间的推移而增加，漏诊率也在增加，这对于咨询患者和手术决策非常重要。重要的是,2/3的患者没有经历滑倒进展。
