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Preoperative conservative treatment is insufficiently described in clinical trials of lumbar fusion: a scoping review – Lumbar Fusion

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This article is a scoping review that aims to identify how pre-surgical conservative care is characterized and reported in randomized controlled trials (RCTs) of adults undergoing elective lumbar fusion. The authors searched multiple databases to find RCTs published between 2005 and 2022 that assessed lumbar fusion as an intervention. Out of 166 studies reviewed, 62% reported a failure in conservative care before lumbar fusion, but only 15.1% provided details about the specific type of conservative care received. Furthermore, none of the trials provided information about the frequency, timing, or dosage of the conservative interventions. The lack of information creates ambiguity in the surgical decision-making process and limits the appropriate clinical application, decision-making, and interpretation of treatment effects. The authors suggest that details about pre-surgical conservative care should be disclosed to address this issue

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: Although roughly two-thirds of trials reported that patients failed conservative care prior to receiving a lumbar fusion, few studies named the conservative intervention provided and no studies provided any details regarding dosing or recency of care. This lack of information creates ambiguity in the surgical decision-making process, setting the assumption that all patients received adequate conservative care prior to surgery. Details about pre-surgical conservative care should be…

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Eur Spine J. 2023 Oct 6. doi: 10.1007/s00586-023-07926-8. Online ahead of print.ABSTRACTPURPOSE: To identify how pre-surgical conservative care is characterized and reported in randomized controlled trials of adults undergoing elective lumbar fusion, including duration and type of treatment.METHODS: The study design is a scoping review. Data sources include PubMed, Cumulative Index to Nursing and Allied,

Eur Spine J. 2023 Oct 6. doi: 10.1007/s00586-023-07926-8. Online ahead of print.

ABSTRACT

PURPOSE: To identify how pre-surgical conservative care is characterized and reported in randomized controlled trials of adults undergoing elective lumbar fusion, including duration and type of treatment.

METHODS: The study design is a scoping review. Data sources include PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ovid Medline, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). All randomized controlled trials published in English between January 1, 2005, and February 15, 2022, assessing lumbar fusion as the intervention were included in this review.

RESULTS: Of 166 studies, 62.0% reported a failure in conservative care prior to lumbar fusion, but only 15.1% detailed the type of specific conservative care received. None of the trials provided sufficient details to understand the nature of the pre-surgical conservative treatment, such as frequency, recency/timing, or dosage of conservative interventions.

: Although roughly two-thirds of trials reported that patients failed conservative care prior to receiving a lumbar fusion, few studies named the conservative intervention provided and no studies provided any details regarding dosing or recency of care. This lack of information creates ambiguity in the surgical decision-making process, setting the assumption that all patients received adequate conservative care prior to surgery. Details about pre-surgical conservative care should be disclosed to allow for appropriate clinical application, decision-making, and interpretation of treatment effects.

PMID:37803158 | DOI:10.1007/s00586-023-07926-8

The London Spine Unit : most advanced treatment clinic in London

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Preoperative conservative treatment is insufficiently described in clinical trials of lumbar fusion: a scoping review

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Eur Spine J. 2023 Oct 6. doi: 10.1007/s00586-023-07926-8. Online ahead of print.ABSTRACTPURPOSE: To identify how pre-surgical conservative care is characterized and reported in randomized controlled trials of adults undergoing elective lumbar fusion, including duration and type of treatment.METHODS: The study design is a scoping review. Data sources include PubMed, Cumulative Index to Nursing and Allied

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