دورية أكاديمية
أعرض في EDS

Interspinous process devices for treatment of degenerative lumbar spine stenosis: A systematic review and meta-analysis.

التفاصيل البيبلوغرافية
العنوان: Interspinous process devices for treatment of degenerative lumbar spine stenosis: A systematic review and meta-analysis.
المؤلفون: Poetscher AW; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Gentil AF; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Ferretti M; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Lenza M; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
المصدر: PloS one [PLoS One] 2018 Jul 06; Vol. 13 (7), pp. e0199623. Date of Electronic Publication: 2018 Jul 06 (Print Publication: 2018).
نوع المنشور: Journal Article; Meta-Analysis; Review; Systematic Review
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Surgical Fixation Devices*, Spinal Stenosis/*surgery, Combined Modality Therapy ; Decompression, Surgical/methods ; Humans ; Magnetic Resonance Imaging ; Publication Bias ; Spinal Stenosis/diagnosis ; Spinal Stenosis/etiology ; Tomography, X-Ray Computed ; Treatment Outcome
مستخلص: Background: Degenerative lumbar spinal stenosis is a condition related to aging in which structural changes cause narrowing of the central canal and intervertebral foramen. It is currently the leading cause for spinal surgery in patients over 65 years. Interspinous process devices (IPDs) were introduced as a less invasive surgical alternative, but questions regarding safety, efficacy, and cost-effectiveness are still unanswered.
Objectives: The aim of this study was to provide complete and reliable information regarding benefits and harms of IPDs when compared to conservative treatment or decompression surgery and suggest directions for forthcoming RCTs.
Methods: We searched MEDLINE, EMBASE, Cochrane Library, Scopus, and LILACS for randomized and quasi-randomized trials, without language or period restrictions, comparing IPDs to conservative treatment or decompressive surgery in adults with symptomatic degenerative lumbar spine stenosis. Data extraction and analysis were conducted following the Cochrane Handbook. Primary outcomes were pain assessment, functional impairment, Zurich Claudication Questionnaire, and reoperation rates. Secondary outcomes were quality of life, complications, and cost-effectiveness. This systematic review was registered at Prospero (International prospective register of systematic reviews) under number 42015023604.
Results: The search strategy resulted in 17 potentially eligible reports. At the end, nine reports were included and eight were excluded. Overall quality of evidence was low. One trial compared IPDs to conservative treatment: IPDs presented better pain, functional status, quality of life outcomes, and higher complication risk. Five trials compared IPDs to decompressive surgery: pain, functional status, and quality of life had similar outcomes. IPD implant presented a significantly higher risk of reoperation. We found low-quality evidence that IPDs resulted in similar outcomes when compared to standard decompression surgery. Primary and secondary outcomes were not measured in all studies and were often published in incomplete form. Subgroup analysis was not feasible. Difficulty in contacting authors may have prevented us of including data in quantitative analysis.
Conclusions: Patients submitted to IPD implants had significantly higher rates of reoperation, with lower cost-effectiveness. Future trials should improve in design quality and data reporting, with longer follow-up periods.
Competing Interests: The authors have declared that no competing interests exist.
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تواريخ الأحداث: Date Created: 20180707 Date Completed: 20181231 Latest Revision: 20230918
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC6034833
DOI: 10.1371/journal.pone.0199623
PMID: 29979691
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0199623