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Is The Interspinous Process Device Safe And Effective In Elderly Patients With Lumbar Degeneration? A Systematic Review And Meta-Analysis Of Randomized Controlled Trials London Spine Lumbar Stenosis

This article is a systematic review and meta-analysis that evaluates the efficacy and safety of interspinous process device (IPD) in the treatment of degenerative lumbar spinal stenosis compared with decompression surgery. The study includes 555 patients and analyzes outcome measures such as the Visual Analogue Scale, Oswestry Disability Index, and Zurich Claudication Questionnaire. The results showed that IPD does not have significant advantages over decompression surgery in terms of pain relief and functional improvement. Additionally, IPD showed no superiority in terms of complications but had higher reoperation rates compared to decompression surgery. However, more clinical studies are needed to determine the effectiveness and safety of IPD

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : finest treatment clinic in UK

Published article

CONCLUSIONS: This systematic review and meta-analysis indicated no superiority in the clinical outcome for IPD compared with decompression surgery. However, more clinical studies are warranted to determine the efficacy and safety of IPD.

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract Background context: Lumbar spinal stenosis is one of the most common diseases affecting the elderly that is characterized by the narrowing of the spinal canal and peripheral neural pathways which may cause back pain and neurogenic intermittent claudication in affected patients. Recently, as an alternative treatment between conservative therapy and decompression surgery, interspinous process,

Abstract

Background context: Lumbar spinal stenosis is one of the most common diseases affecting the elderly that is characterized by the narrowing of the spinal canal and peripheral neural pathways which may cause back pain and neurogenic intermittent claudication in affected patients. Recently, as an alternative treatment between conservative therapy and decompression surgery, interspinous process device (IPD) such as X-stop, Coflex, DIAM, Aperius, Wallis, etc., has gained enough popularity.

Purpose: The purpose of this study was to evaluate the efficacy and safety of IPD in the treatment of degenerative lumbar spinal stenosis compared with decompression surgery.

Study design: This study was a systematic review and meta-analysis of randomized controlled trials.

Patient sample: 555 patients’ samples were collected for this study.

Outcome measures: The Visual Analogue Scale and the Oswestry Disability Index were analyzed, as well as the Zurich Claudication Questionnaire For efficacy evaluation. Complication and reoperation rate was utilized for the assessment of safety.

Methods: A comprehensive literature search was performed through Pubmed, EMBASE, Web of Science, and Cochrane Library until October 2023. Among the studies meeting the eligible criteria, any study in which IPD was utilized in the treatment of degenerative lumbar spinal stenosis was included in the current review. For efficacy evaluation, the Visual Analogue Scale and the Oswestry Disability Index were analyzed, as well as the Zurich Claudication Questionnaire. Complication and reoperation rates were utilized for the assessment of safety.

Results: Five randomized controlled trials with 555 patients were included. There were no significant differences in VAS leg pain (SMD – 0.08, 95% CI – 0.32 to 0.15) and back pain (SMD 0.09, 95%CI-0.27 to 0.45), ODI scores (MD 1.08, 95% CI – 11.23 to 13.39) and ZCQ physical function (MD-0.09, 95% CI-0.22 to 0.05) for IPD compared with decompression surgery. In terms of ZCQ symptom severity (MD – 0.22, 95% CI – 0.27 to – 016), decompression surgery showed superior to the IPD. As for complications (RR 1.08, 95% CI 0.36 to 3.27), the IPD had no advantages compared to decompression surgery, whereas inferior to it in reoperation rate (RR 2.58, 95% CI 1.67 to 3.96).

Conclusions: This systematic review and meta-analysis indicated no superiority in the clinical outcome for IPD compared with decompression surgery. However, more clinical studies are warranted to determine the efficacy and safety of IPD.

Keywords: Decompression; Degenerative lumbar spinal stenosis; Efficacy; Interspinous process device; Safety.

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Is the interspinous process device safe and effective in elderly patients with lumbar degeneration? A systematic review and meta-analysis of randomized controlled trials

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Abstract Background context: Lumbar spinal stenosis is one of the most common diseases affecting the elderly that is characterized by the narrowing of the spinal canal and peripheral neural pathways which may cause back pain and neurogenic intermittent claudication in affected patients. Recently, as an alternative treatment between conservative therapy and decompression surgery, interspinous process

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