Xing-Wen Zhao1, Jian-Xiong Ma2, Xin-Long Ma3, Fei Li4, Wei-Wei He4, Xuan Jiang5, Yin Wang6, Biao Han4, Bin Lu6. 1. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Tianjin Medical University, Tianjin 30070, People's Republic of China. Electronic address: longlongwin@sina.cn. 2. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China. Electronic address: 1638977822@qq.com. 3. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Department of Orthopaedics, Tianjin Hospital, Tianjin 300211, People's Republic of China; Tianjin Medical University, Tianjin 30070, People's Republic of China. Electronic address: 446483619@qq.com. 4. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Tianjin Medical University, Tianjin 30070, People's Republic of China. 5. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Department of Orthopaedics, Tianjin Hospital, Tianjin 300211, People's Republic of China. 6. Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China.
Abstract
BACKGROUND: and purpose: Interspinous process devices (IPD) were widely used for the treatment of lumbar spinal stenosis (LSS). However, whether IPD was superior to bony decompression was still debated. We aimed to compare the clinical outcomes of IPD to bony decompression for LSS. METHODS: PubMed, Cochrane library, Cochrane Central Register of Controlled Trials (CCTR), Ovid Medline, China national knowledge internet database, Wan Fang database were searched in August.8th.2016. Studies were identified using selection criteria and analysed was performed with Review Manager Version 5.3. RESULTS: Four RCTs (seven articles) were included, with 200 patients in the interspinous process devices (IPD) group and 200 patients in bony decompression (DP) group. There was no significant difference in hospital stay time (P = 0.36), VAS leg pain scores (P = 0.83), and complication rates (P = 0.20) for IPD alone versus bony decompression. However, IPD alone showed higher VAS low back pain scores (P = 0.03) and reoperation rates (P < 0.0001) between the two therapy groups. Two studies' results showed the IPD group had lower cost-effectiveness. CONCLUSIONS: Although patients who received IPD may obtain several benefits in the short term, it was associated with higher costs, reoperation rates. Both IPD and bony decompression were acceptable strategies for LSS, but the risks, indications, and costs of IPD should be carefully taken into account before surgery.
BACKGROUND: and purpose: Interspinous process devices (IPD) were widely used for the treatment of lumbar spinal stenosis (LSS). However, whether IPD was superior to bony decompression was still debated. We aimed to compare the clinical outcomes of IPD to bony decompression for LSS. METHODS: PubMed, Cochrane library, Cochrane Central Register of Controlled Trials (CCTR), Ovid Medline, China national knowledge internet database, Wan Fang database were searched in August.8th.2016. Studies were identified using selection criteria and analysed was performed with Review Manager Version 5.3. RESULTS: Four RCTs (seven articles) were included, with 200 patients in the interspinous process devices (IPD) group and 200 patients in bony decompression (DP) group. There was no significant difference in hospital stay time (P = 0.36), VAS leg pain scores (P = 0.83), and complication rates (P = 0.20) for IPD alone versus bony decompression. However, IPD alone showed higher VAS low back pain scores (P = 0.03) and reoperation rates (P < 0.0001) between the two therapy groups. Two studies' results showed the IPD group had lower cost-effectiveness. CONCLUSIONS: Although patients who received IPD may obtain several benefits in the short term, it was associated with higher costs, reoperation rates. Both IPD and bony decompression were acceptable strategies for LSS, but the risks, indications, and costs of IPD should be carefully taken into account before surgery.
Authors: Mateusz Krakowiak; Natalia Rulewska; Marcin Rudaś; Maciej Broda; Michał Sabramowicz; Andrzej Jaremko; Krzysztof Leki; Paweł Sokal Journal: J Pain Res Date: 2022-07-14 Impact factor: 2.832