Hospitalisations resulting from infection, tumours, injury and spinal deformities such as scoliosis are excluded from this analysis. Lumbar spinal fusion is a type of surgery that is sometimes used to treat chronic low back pain and other symptoms of degenerative spinal disorders. Lumbar fusion is an accepted and effective technique for the treatment of lumbar degenerative disease. Jorgenson SS et al. The Commission consulted widely, but is solelyresponsible for making the recommendations; assuch, the recommendations may not reflecttheviews of all contributors to the Atlas. All tools and processes will be piloted prior to use. NH, MV, and PW contributed to the protocol development and will contribute to the interpretation of the data. JBS is leading the protocol development and dissemination. Dimar 2nd JR et al. Moreover, LSF is not without any risks given the incidence of graft-specific complications (5.410.0% [1416]) and revisions (2.06.9% [1721]). The data presents the modified version of the Quality in Prognostic Studies (QUIPs) tool which will be used to assess risk of bias of included studies. This relieves pain by making a spinal fracture more stable and preventing painful movements. When judging the veteran's range of motion, doctors measure the maximum angle of movement before . In case of missing data, authors will be contacted to provide additional information. An activity listed under a descriptor cannot be taken as being able to be performed if it can only be performed once or rarely - the person needs to be able to usually perform such activity whenever they would normally attempt it or be required to perform it. Spinal fusion may be considered a disability if the patient meets certain qualifications, including specific mobility restrictions. Titles and abstracts (stage 1) followed by full-texts of potentially relevant studies (stage 2) will be independently screened by two reviewers (NK and TH). [36] (VAS 15, NRS 2, ODI 10, RDQ 5, QBPDQ 20) will be used to interpret results and draw conclusions regarding a satisfying or disappointing natural course of pain and disability after LSF. Neurosurg Focus. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. The main goal of this systematic review is to determine the effect of perioperative psychological interventions on pain, disability and health-related quality of life (HRQOL) in patients undergoing spinal fusion surgery at any level of the spine, at short-term ( 3 months), intermediate-term (> 3 months but < 12 months) and long-term ( 12 months) follow-up. Secondly, it is possible that the continuous outcome data on the same construct needs to be converted to a 0 to 100 scale or percentage to increase comparability of data between studies [36]. Pekkanen et al. (DOCX 27kb)Additional file 2: Table S1. 2009;151(4):2649. Inpatient outcomes and post-operative complications following primary versus revision lumbar spinal fusion surgeries for degenerative lumbar disc disease: a National (Nationwide) Inpatient Sample analysis 2002-2011. 2005;30(8):93643. The statistical heterogeneity will be analysed using the I2 [33]. [30]. Inclusion in an NLM database does not imply endorsement of, or agreement with, Data for each included study will be extracted using a standardized form managed in Microsoft Access (Microsoft Corporation, Seattle, WA, USA). There must be corroborating medical evidence of the person's impairment. iv. Disagreements will be solved by consensus. Neurosurg Focus. 5). Discussion 538539. The VA assigns a rating to spinal fusion in the same way it rates other diseases of the spine, basing its rating on a veteran's range of motion as defined by 38 CFR 4.71a, Schedule of Ratings - Musculoskeletal System (Diagnostic Code 5241).. The results could provide valuable information what would improve our understanding of recovery after LSF and serve as a rigid foundation for comparison of LSF outcomes of future studies. But as with any surgery, spinal fusion carries some risks. Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review. Cost-effectiveness of lumbar discectomy and single-level fusion for spondylolisthesis: experience with the NeuroPoint-SD registry. The fusing of the vertebrae keeps them from moving out of place, which is a well-known cause of back pain and discomfort. Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review. Journal of Statistical Software 43.1: CRC Press; 2009. Lumbar spinal fusion surgery has a role in treating a small number of people who have degenerative spinal disorders with nerve-related problems. This systematic review and meta-analysis will provide an overview of the natural course of pain and disability in patients with degenerative disorders of the lumbar spine after first-time LSF surgery. Vaccaro AR, Stubbs HA, Block JE. NK drafted the protocol and leads search of eligible studies. Under the 10-point descriptor on Table 4 the person would meet (1)(c). Types of Spinal Fusion That Are a Disability sharing sensitive information, make sure youre on a federal BMJ. Spinal fusion can also stabilize the back for people with conditions that cause spine instability, like lumbar spondylolisthesis ("slipped discs"), fractured vertebrae ("back bones"), or tumors. This study aims to systematically review and meta-analyse the natural course of pain and disability in patients with degenerative disorders of the lumbar spine such as spinal stenosis, spondylolisthesis, disc herniation, or discogenic low back pain to improve lumbar spinal fusion management. The data shows a completed copy of the PRISMA checklist to guide readers in assessment of the quality of the current review protocol article. CAS By using this website, you agree to our 10), a modified funnel plot (Fig. If missing values (i.e. 2008;8(5):74755. Studies will be assessed based on the domains of representation of sample, definition of study sample, study attrition, outcome measurement, confounding, statistical analysis, provision of data, and blinding of outcomes (modified version: Additional file 4). The risk of bias of included studies will be assessed with the modified version of the Quality in Prognostic Studies tool. Where no abstract is available, full-text articles will be obtained unless the article can be confidently excluded by its title alone. Analysis by remoteness and socioeconomic status, Analysis by Aboriginal and Torres Strait Islander status, High-quality research and outcome monitoring, Hover or click on maps and graphs for details of data points, Use the dropdown boxes at the bottom of graphs to select states and territories,SA3sor PHNs, Spinal stenosis (lumbar and lumbosacral), 36%, Lumbar and other intervertebral disc disorders with radiculopathy, 21%, Spondylolisthesis (lumbar and lumbosacral), 25%, Radiculopathy (lumbar and lumbosacral), 5%, Other specified intervertebral disc displacement, 5%, Lumbar and other intervertebral disc disorders with myelopathy, 1%. Eur Spine J. Tosteson AN, et al. As a library, NLM provides access to scientific literature. Description of data: The data provided shows an example of a comprehensive electronic search conducted in MEDLINE. Determination of the descriptor that best fits the person's impairment level must be based on the available medical evidence including the person's medical history, investigation results and clinical findings. The authors are academic staff at Radboud University Medical Centre, University of Birmingham, Bern University Hospital, and Maastricht University Medical Centre. PubMed Saltychev M, Laimi K. Re: Phillips FM, Slosar PJ, Youssef JA, et al. Unspecified dorsalgia (lumbar and lumbosacral) and other dorsalgia (lumbar and lumbosacral), 1%. 1 Spinal pathologies leading to LSF are heterogeneous. The results could provide valuable information what would improve our understanding of recovery after LSF and serve as a rigid foundation for comparison of LSF outcomes of future studies. If a person has difficulty with mobility relating to a restricted ability to undertake activities involving physical exertion, this must be assessed under Table 1 Functions requiring Physical Exertion and Stamina. A modification of a standard funnel plot [27] is needed to assess selective publication of change on pain and disability outcomes in relation to the study sample size. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. Pain and disability outcome measures are primary outcomes and will be measured with, for example, Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), Roland Disability Questionnaire (RDQ), or Quebec Back Pain Disability Questionnaire (QBPDQ). The Table 4 descriptors are to be met only from spinal conditions. Bethesda, MD 20894, Web Policies Terms and Conditions, Pekkanen L et al. Outcomes for single-level lumbar fusion: the role of bone morphogenetic protein. Cite this article. World Neurosurg. Complications associated with single-level transforaminal lumbar interbody fusion. Furthermore, a search in the British National Bibliography for Report Literature and OpenGrey will be performed to identify unpublished studies. Disabil Rehabil. The descriptors in each Table follow an incremental hierarchy, which is expressed among other things, by the use of terms indicating increasing levels of difficulty in performing certain activities. 2008;33(1):904. Ostelo RW, et al. For example, under the 20-point descriptor, if a person is able to remain seated for 10 minutes but suffers severe pain while doing so, it should be considered that the person is unable to remain seated for at least 10 minutes. The Fourth Atlas 2021 shows trends over time. Before (37K, docx)Possible determinants for effect modification (DOCX 37kb)Additional file 4:(26K, docx)Modified QUIPs tool. Note 1: Individual descriptors or their parts must not be applied in isolation from one another. Finally, the positive effect of LSF on patients with chronic low back pain seems to decrease at longer follow-up [24]. This clarification is important to ensure it is spinal function, not upper limb function that is being assessed. Koenders, N., Rushton, A., Heneghan, N. et al. [36] (VAS 15, NRS 2, ODI 10, RDQ 5, QBPDQ 20) will be used to interpret results and draw conclusions regarding a satisfying or disappointing natural course of pain and disability after LSF. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Variance-weighted pooled estimates of outcomes will be calculated for the continuous data [29]. Where possible, data will be pooled and analysed within the same surgical procedure. Health service organisations where lumbarspinal surgery is conducted to implementevidence-based guidelines; for example, theNational Institute for Health and Care Excellenceguidelines: Low Back Pain and Sciatica in Over16s: Assessment and management. Cohens will be used to assess agreement between the reviewers. Rajaee SS et al. Rihn JA et al. spinal fusion for infection, tumours, injury and spinal deformities such as scoliosis, and therefore focuses on the use of spinal fusion for degenerative spinal disorders and associated chronic low back pain. PubMed Central The results will be reported in accordance with the PRISMA statement and its checklist [28]. Clinical and radiographic analysis of an optimized rhBMP-2 formulation as an autograft replacement in posterolateral lumbar spine arthrodesis. In some cases, certain claimants may be entitled to disability benefits, both short-term and long-term, following a spinal fusion. Improve the evidence base for the comparative effectiveness of lumbar spinal fusion in the treatment of chronic low back pain, and the associated risks of this surgical procedure. There was no funding for development of this review protocol and there will be no funding for performing the systematic review. This study aims to systematically review and meta-analyse the natural course of pain and disability in patients with degenerative disorders of the lumbar spine such as spinal stenosis, spondylolisthesis, disc herniation, or discogenic low back pain to improve lumbar spinal fusion management. Introduction. Spine (Phila Pa 1976). Google Scholar. In addition, a search for articles in press and published ahead of print will be conducted in relevant journals for spine surgery (e.g. In determining the level of functional impact, care should be taken to distinguish between activities that the person does not do as opposed to activities that they have difficulty performing because of their impairment. Risk of bias for each included study will be independently assessed by the same initial reviewers (NK and TH); the third reviewer (AR) will mediate in situations of disagreement. Prior to data extraction, piloting of the form will be conducted in a small number of studies (e.g. Mummaneni PV et al. Comparative effectiveness evidence from the spine patient outcomes research trial: surgical versus nonoperative care for spinal stenosis, degenerative spondylolisthesis, and intervertebral disc herniation. NO descriptors or their parts are to be disregarded. Saltychev M, Laimi K. Re: Phillips FM, Slosar PJ, Youssef JA, et al. Conditions causing impairment commonly assessed using Table 4 These include but are not limited to: spinal cord injury spinal stenosis cervical spondylosis and radiculopathy lumbar radiculopathy herniated or ruptured spinal disc spinal cord tumours chronic pain affecting the spine Burkus JK et al. Cost-effectiveness of lumbar fusion and nonsurgical treatment for chronic low back pain in the Swedish Lumbar Spine Study: a multicenter, randomized, controlled trial from the Swedish Lumbar Spine Study Group.
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