PURPOSE: To investigate what interventions can improve walking ability in neurogenic claudication with lumbar spinal stenosis. METHODS: We searched CENTRAL, Medline, EMBASE, CINAHL and ICL databases up to June 2012. Only randomized controlled trials published in English and measuring walking ability were included. Data extraction, risk of bias assessment, and quality of the evidence evaluation were performed using methods of the Cochrane Back Review Group. RESULTS: We accepted 18 studies with 1,220 participants. There is very low quality evidence that calcitonin is no better than placebo or paracetamol regardless of mode of administration. There is low quality evidence that prostaglandins, and very low quality evidence that gabapentin or methylcobalamin, improves walking distance. There is low and very low quality evidence that physical therapy was no better in improving walking ability compared to no treatment, oral diclofenac plus home exercises, or combined manual therapy and exercise. There is very low quality evidence that epidural injections improve walking distance up to 2 weeks compared to placebo. There is low- and very low-quality evidence that various direct decompression surgical techniques show similar significant improvements in walking ability. There is low quality evidence that direct decompression is no better than non-operative treatment in improving walking ability. There is very low quality evidence that indirect decompression improves walking ability compared to non-operative treatment. CONCLUSIONS: Current evidence for surgical and non-surgical treatment to improve walking ability is of low and very low quality and thus prohibits recommendations to guide clinical practice.
PURPOSE: To investigate what interventions can improve walking ability in neurogenic claudication with lumbar spinal stenosis. METHODS: We searched CENTRAL, Medline, EMBASE, CINAHL and ICL databases up to June 2012. Only randomized controlled trials published in English and measuring walking ability were included. Data extraction, risk of bias assessment, and quality of the evidence evaluation were performed using methods of the Cochrane Back Review Group. RESULTS: We accepted 18 studies with 1,220 participants. There is very low quality evidence that calcitonin is no better than placebo or paracetamol regardless of mode of administration. There is low quality evidence that prostaglandins, and very low quality evidence that gabapentin or methylcobalamin, improves walking distance. There is low and very low quality evidence that physical therapy was no better in improving walking ability compared to no treatment, oral diclofenac plus home exercises, or combined manual therapy and exercise. There is very low quality evidence that epidural injections improve walking distance up to 2 weeks compared to placebo. There is low- and very low-quality evidence that various direct decompression surgical techniques show similar significant improvements in walking ability. There is low quality evidence that direct decompression is no better than non-operative treatment in improving walking ability. There is very low quality evidence that indirect decompression improves walking ability compared to non-operative treatment. CONCLUSIONS: Current evidence for surgical and non-surgical treatment to improve walking ability is of low and very low quality and thus prohibits recommendations to guide clinical practice.
Authors: James F Zucherman; Ken Y Hsu; Charles A Hartjen; Thomas F Mehalic; Dante A Implicito; Michael J Martin; Donald R Johnson; Grant A Skidmore; Paul P Vessa; James W Dwyer; Stephen T Puccio; Joseph C Cauthen; Richard M Ozuna Journal: Spine (Phila Pa 1976) Date: 2005-06-15 Impact factor: 3.468
Authors: Ashley R Wilson-Smith; Saimurooban Muralidaran; Monish Maharaj; Matthew H Pelletier; Peter Beshara; Prashanth Rao; Louise M Pearce; Tian Wang; Ralph J Mobbs; William R Walsh Journal: J Spine Surg Date: 2022-03
Authors: Carlo Ammendolia; Michael Schneider; Kelly Williams; Susan Zickmund; Megan Hamm; Kent Stuber; Christy Tomkins-Lane; Y Raja Rampersaud Journal: J Can Chiropr Assoc Date: 2017-03
Authors: Christy Tomkins-Lane; Markus Melloh; Jon Lurie; Matt Smuck; Michele C Battié; Brian Freeman; Dino Samartzis; Richard Hu; Thomas Barz; Kent Stuber; Michael Schneider; Andrew Haig; Constantin Schizas; Jason Pui Yin Cheung; Anne F Mannion; Lukas Staub; Christine Comer; Luciana Macedo; Sang-Ho Ahn; Kazuhisa Takahashi; Danielle Sandella Journal: Spine (Phila Pa 1976) Date: 2016-08-01 Impact factor: 3.241