Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Jun 7;103(23):e38370.
doi: 10.1097/MD.0000000000038370.

Efficacy and safety of interspinous process device compared with alone decompression for lumbar spinal stenosis: A systematic review and meta-analysis

Changjiu Zhu  1 , Guiling Xiao
Affiliations
Meta-Analysis

Efficacy and safety of interspinous process device compared with alone decompression for lumbar spinal stenosis: A systematic review and meta-analysis

Changjiu Zhu et al. Medicine (Baltimore). .

Abstract

Study design: Systematic review and meta-analysis.

Background: Interspinous process devices (IPD) were used as a treatment in selected patients with lumbar spinal stenosis (LSS). However, the use of IPD was still debated that it had significantly higher reoperation rates compared to traditional decompression. Therefore, the purpose of the meta-analysis was to evaluate the effectiveness and safety of IPD treatment in comparison to traditional treatment.

Methods: The databases were searched of PubMed, Embase and the Cochrane, Chinese National Knowledge Infrastructure, Chongqing VIP Database and Wan Fang Database up to January 2024. Relevant studies were identified by using specific eligibility criteria and data was extracted and analyzed based on primary and secondary endpoints.

Results: A total of 13 studies were included (5 RCTs and 8 retrospective studies). There was no significant difference of Oswestey Disability Index (ODI) score in the last follow-up (MD = -3.81, 95% CI: -8.91-1.28, P = .14). There was significant difference of Visual Analog Scale (VAS) back pain scoring in the last follow-up (MD = -1.59, 95% CI: -3.09--0.09, P = .04), but there existed no significant difference of leg pain in the last follow-up (MD = -2.35, 95% CI: -6.15-1.45, P = .23). What's more, operation time, bleeding loss, total complications and reoperation rate had no significant difference. However, IPD had higher device problems (odds ratio [OR] = 9.00, 95% CI: 2.39-33.91, P = .001) and lesser dural tears (OR = 0.32, 95% CI: 0.15-0.67, P = .002) compared to traditional decompression.

Conclusion: Although IPD had lower back pain score and lower dural tears compared with traditional decompression, current evidence indicated no superiority for patient-reported outcomes for IPD compared with alone decompression treatment. However, these findings needed to be verified in further by multicenter, double-blind and large sample RCTs.

PubMed Disclaimer

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
The flowchart of the study.
Figure 2.
Figure 2.
A forest plot showing the ODI score.
Figure 3.
Figure 3.
A forest plot showing the VAS score for back pain.
Figure 4.
Figure 4.
A forest plot showing the VAS score for leg pain.
Figure 5.
Figure 5.
A forest plot showing the hospital time.
Figure 6.
Figure 6.
A forest plot showing the blood loss.
Figure 7.
Figure 7.
A forest plot showing the total complications.
Figure 8.
Figure 8.
A forest plot showing the reoperation rate.
Figure 9.
Figure 9.
A forest plot showing the device problems.
Figure 10.
Figure 10.
A forest plot showing the dural tears.
Figure 11.
Figure 11.
A forest plot showing the anterior disc height.
Figure 12.
Figure 12.
A forest plot showing the posterior disc height.
Figure 13.
Figure 13.
A funnel plot showing publication bias.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Johnsson KE. Lumbar spinal stenosis. A retrospective study of 163 cases in southern Sweden. Acta Orthop Scand. 1995;66:403–5. - PubMed
    1. Hicks GE, Morone N, Weiner DK. Degenerative lumbar disc and facet disease in older adults: prevalence and clinical correlates. Spine. 2009;34:1301–6. - PMC - PubMed
    1. Schulte TL, Bullmann V, Lerner T, et al. . Lumbar spinal stenosis. Orthopade. 2006;35:675–92; quiz 693. - PubMed
    1. Siebert E, Prüss H, Klingebiel R, Failli V, Einhäupl KM, Schwab JM. Lumbar spinal stenosis: syndrome, diagnostics and treatment. Nat Rev Neurol. 2009;5:392–403. - PubMed
    1. Sinikallio S, Aalto T, Airaksinen O, et al. . Depression is associated with poorer outcome of lumbar spinal stenosis surgery. Eur Spine J. 2007;16:905–12. - PMC - PubMed

MeSH terms