Spine
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Review Meta Analysis Comparative Study
Surgery versus conservative treatment for symptomatic lumbar spinal stenosis: a systematic review of randomized controlled trials.
Systematic review. ⋯ In patients with symptomatic LSS, the implantation of a specific type of device or decompressive surgery, with or without fusion, is more effective than continued conservative treatment when the latter has failed for 3 to 6 months.
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Review Meta Analysis
Physiotherapy rehabilitation post first lumbar discectomy: a systematic review and meta-analysis of randomized controlled trials.
Systematic review and meta-analysis. ⋯ Inconclusive evidence exists for the effectiveness of outpatient physiotherapy post first lumbar discectomy. Best practice remains unclear.
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Review Meta Analysis
Spinal manipulative therapy for chronic low-back pain: an update of a Cochrane review.
Systematic review of interventions. ⋯ High-quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain. Determining cost-effectiveness of care has high priority.
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Meta Analysis Comparative Study
High-dose ketorolac affects adult spinal fusion: a meta-analysis of the effect of perioperative nonsteroidal anti-inflammatory drugs on spinal fusion.
Meta-analysis of literature. ⋯ Although randomized controlled trials would be optimal for meta-analyses, the data of this review revealed that short-time (<14 days) exposure to normal-dose NSAIDs (ketorolac, diclofenac sodium, celecoxib, or rofecoxib) were safe after spinal fusion, whereas short-time (<14 days) exposure to high-dose ketorolac increased the risk of nonunion, which meant that the effect of perioperative NSAIDs on spinal fusion might be dose-dependent. Further studies would be needed to find out whether long-time exposure to normal-dose NSAIDs could also increase the risk of nonunion and which type of NSAIDs would like to have a worse effect on spinal fusion.
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Meta Analysis Comparative Study
Calcitonin treatment in lumbar spinal stenosis: a meta-analysis.