Clinical Evaluation of Surgery for Single‐Segment Lumbar Spinal Stenosis: A Systematic Review and Bayesian Network Meta‐Analysis
To compare the efficacy and safety of different surgical procedures for patients with single‐segment lumbar spinal stenosis (LSS), Bayesian network meta‐analysis (NMA) was conducted in this study. Randomized controlled trials (RCTs) which reported 2 years' results after surgery were searched fr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-07-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13269 |
| _version_ | 1811318856725037056 |
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| author | Zeyan Liang Xiongjie Xu Xinyao Chen Yuandong Zhuang Rui Wang Chunmei Chen |
| author_facet | Zeyan Liang Xiongjie Xu Xinyao Chen Yuandong Zhuang Rui Wang Chunmei Chen |
| author_sort | Zeyan Liang |
| collection | DOAJ |
| description | To compare the efficacy and safety of different surgical procedures for patients with single‐segment lumbar spinal stenosis (LSS), Bayesian network meta‐analysis (NMA) was conducted in this study. Randomized controlled trials (RCTs) which reported 2 years' results after surgery were searched from PubMed, Embase, and Cochrane Register of Controlled Trials up to February 2021. Eligible RCTs that contained at least two of the following surgical procedures, bilateral decompression via the unilateral approach (BDUL), decompression with conventional laminectomy (CL), decompression with fusion (DF), endoscopic decompression (ED), interspinous process devices only (IPDs), decompression with interlaminar stabilization (DILS), decompression with lumbar spinal process‐splitting laminectomy (LSPSL), and minimally invasive tubular decompression (MTD), would be included after screening based on the inclusion and exclusion criteria. The primary outcome was Oswestry Disability Index (ODI). Twenty eligible RCTs were included, with a total of 2201 patients enrolled. The NMA showed that the following surgical procedures ranked first (surface under the cumulative ranking) when compared with CL and DF: DILS for ODI (SUCRA 87.8%); LSPSL for back pain (95%); and MTD for leg pain (95.6%). MTD ranked among the top three surgical procedures for most outcomes. The quality of the synthesized evidence was low according to the Grading of Recommendations Assessment, Development, and Evaluation criteria. DILS, LSPSL, MTD, IPDs, and ED are the most effective procedures for patients with single‐segment LSS. Because of combining efficacy and safety, MTD may be the most promising routine surgical option for treating single‐segment LSS. |
| first_indexed | 2024-04-13T12:32:30Z |
| format | Article |
| id | doaj.art-3eec2bffc6ed45139ed4f7cb48bfc2e0 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-13T12:32:30Z |
| publishDate | 2022-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-3eec2bffc6ed45139ed4f7cb48bfc2e02022-12-22T02:46:47ZengWileyOrthopaedic Surgery1757-78531757-78612022-07-011471281129310.1111/os.13269Clinical Evaluation of Surgery for Single‐Segment Lumbar Spinal Stenosis: A Systematic Review and Bayesian Network Meta‐AnalysisZeyan Liang0Xiongjie Xu1Xinyao Chen2Yuandong Zhuang3Rui Wang4Chunmei Chen5Department of Neurosurgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Neurosurgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Neurosurgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Neurosurgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Neurosurgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Neurosurgery Fujian Medical University Union Hospital Fuzhou ChinaTo compare the efficacy and safety of different surgical procedures for patients with single‐segment lumbar spinal stenosis (LSS), Bayesian network meta‐analysis (NMA) was conducted in this study. Randomized controlled trials (RCTs) which reported 2 years' results after surgery were searched from PubMed, Embase, and Cochrane Register of Controlled Trials up to February 2021. Eligible RCTs that contained at least two of the following surgical procedures, bilateral decompression via the unilateral approach (BDUL), decompression with conventional laminectomy (CL), decompression with fusion (DF), endoscopic decompression (ED), interspinous process devices only (IPDs), decompression with interlaminar stabilization (DILS), decompression with lumbar spinal process‐splitting laminectomy (LSPSL), and minimally invasive tubular decompression (MTD), would be included after screening based on the inclusion and exclusion criteria. The primary outcome was Oswestry Disability Index (ODI). Twenty eligible RCTs were included, with a total of 2201 patients enrolled. The NMA showed that the following surgical procedures ranked first (surface under the cumulative ranking) when compared with CL and DF: DILS for ODI (SUCRA 87.8%); LSPSL for back pain (95%); and MTD for leg pain (95.6%). MTD ranked among the top three surgical procedures for most outcomes. The quality of the synthesized evidence was low according to the Grading of Recommendations Assessment, Development, and Evaluation criteria. DILS, LSPSL, MTD, IPDs, and ED are the most effective procedures for patients with single‐segment LSS. Because of combining efficacy and safety, MTD may be the most promising routine surgical option for treating single‐segment LSS.https://doi.org/10.1111/os.13269bayesian network meta‐analysislumbar spinal stenosisrandomized controlled trialssurgical procedures |
| spellingShingle | Zeyan Liang Xiongjie Xu Xinyao Chen Yuandong Zhuang Rui Wang Chunmei Chen Clinical Evaluation of Surgery for Single‐Segment Lumbar Spinal Stenosis: A Systematic Review and Bayesian Network Meta‐Analysis Orthopaedic Surgery bayesian network meta‐analysis lumbar spinal stenosis randomized controlled trials surgical procedures |
| title | Clinical Evaluation of Surgery for Single‐Segment Lumbar Spinal Stenosis: A Systematic Review and Bayesian Network Meta‐Analysis |
| title_full | Clinical Evaluation of Surgery for Single‐Segment Lumbar Spinal Stenosis: A Systematic Review and Bayesian Network Meta‐Analysis |
| title_fullStr | Clinical Evaluation of Surgery for Single‐Segment Lumbar Spinal Stenosis: A Systematic Review and Bayesian Network Meta‐Analysis |
| title_full_unstemmed | Clinical Evaluation of Surgery for Single‐Segment Lumbar Spinal Stenosis: A Systematic Review and Bayesian Network Meta‐Analysis |
| title_short | Clinical Evaluation of Surgery for Single‐Segment Lumbar Spinal Stenosis: A Systematic Review and Bayesian Network Meta‐Analysis |
| title_sort | clinical evaluation of surgery for single segment lumbar spinal stenosis a systematic review and bayesian network meta analysis |
| topic | bayesian network meta‐analysis lumbar spinal stenosis randomized controlled trials surgical procedures |
| url | https://doi.org/10.1111/os.13269 |
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