Review Meta Analysis
- Mariam ElSaban, Donald J Kleppel, Eva Kubrova, Martinez AlvarezGabriel AGA0000-0002-8443-2980Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA., Nasir Hussain, and Ryan S D'Souza.
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA.
- Reg Anesth Pain Med. 2023 Jun 1; 48 (6): 302311302-311.
BackgroundSpinal cord stimulation (SCS) has emerged as an important treatment for chronic pain disorders. While there is evidence supporting improvement in pain intensity with SCS therapy, efforts to synthesize the evidence on physical functioning are lacking.ObjectiveThe primary objective of this meta-analysis was to assess long-term physical function following 12 months of SCS for chronic back pain.Evidence ReviewPubMed, EMBASE, Scopus, and CENTRAL databases were searched for original peer-reviewed publications investigating physical function following SCS. The primary outcome was physical function at 12 months following SCS therapy for chronic back pain compared with baseline. A random effects model with an inverse variable method was used. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) framework was used to determine the certainty of evidence.FindingsA total of 518 studies were screened, of which 36 were included. Twenty-two studies were pooled in the meta-analysis. There was a significant reduction in Oswestry Disability Index (ODI) scores at all time frames up to 24 months following implantation. Pooled results revealed significant improvement in ODI scores at 12 months with a mean difference of -17.00% (95% CI -23.07 to -10.94, p<0.001). There was a very low certainty of evidence in this finding as per the GRADE framework. There was no significant difference in subgroup analyses based on study design (randomised controlled trials (RCTs) vs non-RCTs), study funding, or stimulation type.ConclusionThis meta-analysis highlights significant improvements in physical function after SCS therapy. However, this finding was limited by a very low GRADE certainty of evidence and high heterogeneity.© American Society of Regional Anesthesia & Pain Medicine 2023. No commercial re-use. See rights and permissions. Published by BMJ.
Knowledge, pearl, summary or comment to share?
You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
- Superscript can be denoted by
- Numbered or bulleted lists can be created using either numbered lines
1. 2. 3., hyphens
- Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)inline.
- Or use an inline reference
[^1]to refer to a longer footnote elseweher in the document
[^1]: This is a long footnote..