Cochrane · systematic review · CD012421
Surgical options for lumbar spinal stenosis
Machado, GC, Ferreira, PH, Yoo, RIJ, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Back and NeckAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
15
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 5 · 33.3%Low 5 · 33.3%Moderate 3 · 20%High 2 · 13.3%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
SUMMARY OF FINDINGS FOR DECOMPRESSION VERSUS FUSION
Population: patients with lumbar spinal stenosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain Long‐term (≥ 12 months) Pain scores converted to 0 to 100 scale to allow for comparison of different disability scales (VAS, NRS) SUMMARY OF FINDINGS FOR DECOMPRESSION vs FUSION | no estimate extracted | 4 studies · 380 participants | Very low |
Disability Long‐term (≥ 12 months) Disability scores converted to 0 to 100 scale to allow for comparison of different disability scales (RMDQ, ODI, JOA) SUMMARY OF FINDINGS FOR DECOMPRESSION vs FUSION | Mean difference 3.26 | 3 studies · 335 participants | Very low |
Operation time Duration of operation reported in minutes SUMMARY OF FINDINGS FOR DECOMPRESSION vs FUSION | no estimate extracted | 4 studies · 381 participants | Very low |
Blood loss Amount of perioperative blood loss reported in L SUMMARY OF FINDINGS FOR DECOMPRESSION vs FUSION | no estimate extracted | 4 studies · 383 participants | Very low |
Reoperations Number of patients requiring a revision surgery SUMMARY OF FINDINGS FOR DECOMPRESSION vs FUSION | Risk ratio 1.25 [0.81, 1.92] | 5 studies · 443 participants | Moderate |
SUMMARY OF FINDINGS FOR DECOMPRESSION VERSUS INTERSPINOUS SPACERS
Population: patients with lumbar spinal stenosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain Long‐term (≥ 12 months) Pain scores converted to 0 to 100 scale to allow for comparison of different disability scales (VAS, NRS) SUMMARY OF FINDINGS FOR DECOMPRESSION vs INTERSPINOUS SPACERS | no estimate extracted | 3 studies · 328 participants | Moderate |
Disability Long‐term (≥ 12 months) Disability scores converted to 0 to 100 scale to allow for comparison of different disability scales (RMDQ, ODI, JOA) SUMMARY OF FINDINGS FOR DECOMPRESSION vs INTERSPINOUS SPACERS | Mean difference 1.25 | 3 studies · 327 participants | Low |
Operation time Duration of operation reported in minutes SUMMARY OF FINDINGS FOR DECOMPRESSION vs INTERSPINOUS SPACERS | Mean difference 39.11 [19.43, 58.78] | 3 studies · 340 participants | Low |
Blood loss Amount of perioperative blood loss reported in mL SUMMARY OF FINDINGS FOR DECOMPRESSION vs INTERSPINOUS SPACERS | Mean difference 144 | 1 study · 81 participants | Low |
Reoperations Number of patients requiring a revision surgery SUMMARY OF FINDINGS FOR DECOMPRESSION vs INTERSPINOUS SPACERS | Risk ratio 0.25 [0.14, 0.47] | 3 studies · 326 participants | High |
SUMMARY OF FINDINGS FOR FUSION VERSUS INTERSPINOUS SPACERS
Population: patients with lumbar spinal stenosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain Long‐term (≥ 12 months) Pain scores converted to 0 to 100 scale to allow for comparison of different disability scales (VAS, NRS) SUMMARY OF FINDINGS FOR FUSION vs INTERSPINOUS SPACERS | Mean difference 5.35 | 2 studies · 308 participants | Low |
Disability Long‐term (≥ 12 months) Disability scores converted to 0 to 100 scale to allow for comparison of different disability scales (RMDQ, ODI, JOA) SUMMARY OF FINDINGS FOR FUSION vs INTERSPINOUS SPACERS | Mean difference 5.72 [1.28, 10.15] | 2 studies · 308 participants | Low |
Operation time Duration of operation reported in minutes SUMMARY OF FINDINGS FOR FUSION vs INTERSPINOUS SPACERS | Mean difference 78.91 [30.16, 127.65] | 2 studies · 381 participants | Very low |
Blood loss Amount of perioperative blood loss reported in mL SUMMARY OF FINDINGS FOR FUSION vs INTERSPINOUS SPACERS | Mean difference 238.9 [182.66, 295.14] | 1 study · 320 participants | Moderate |
Reoperations Number of patients requiring a revision surgery SUMMARY OF FINDINGS FOR FUSION vs INTERSPINOUS SPACERS | Risk ratio 0.7 [0.32, 1.51] | 1 study · 322 participants | High |