SynthesisBMC medicine2024
Surgical interventions for degenerative lumbar spinal stenosis: a systematic review with network meta-analysis.
Synthesis in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Material and Geometric Innovations in Lumbar and Cervical Interbody Devices: A Systematic Scoping Review.Annals of biomedical engineering · 2026Review
- Interlaminar versus sublaminar lumbar decompression: a retrospective study on patient satisfaction as measured by PROMIS outcomes.Journal of spine surgery (Hong Kong) · 2026Article
- Percutaneous Endoscopic Lumbar Decompression Using a Novel L-Shaped Impactor for Treating Lumbar Foraminal and Nerve Root Canal Stenosis in Elderly Patients With High Iliac Crests: A Retrospective Cohort Study.Orthopaedic surgery · 2026Article
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- Robotic-assisted midline lumbar interbody fusion for the treatment of degenerative lumbar spinal stenosis: a prospective, randomized, controlled, non-inferiority clinical trial protocol.Journal of spine surgery (Hong Kong) · 2026Article
- Perioperative coagulation shifts after degenerative lumbar surgery and exploratory lower-limb thrombosis signals.Frontiers in surgery · 2026Article
- Threshold-Anchored Mechanomyography Metrics for Patient Stratification in Spinal Decompression: Associations with Early Pain Outcomes.Journal of personalized medicine · 2025Article
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Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral surgical options for degenerative lumbar spinal stenosis (LSS) are available, but current guidelines do not recommend which one should be prioritized. Although previous network meta-analyses (NMAs) have been performed on this topic, they have major methodological problems and could not provide the convincing evidence and clinical practical information required.
methodsRandomized controlled trials (RCTs) comparing at least two surgical interventions were included by searching AMED, CINAHL, EMBASE, the Cochrane Library, and MEDLINE (inception to August 2023). A frequentist random-effects NMA was performed for physical function and adverse events due to any reason. For physical function, three follow-up time points were included: short-term (< 6 months post-intervention), mid-term (≥ 6 months but < 12 months), and long-term (≥ 12 months). Laminectomy was the reference comparison intervention.
resultsA total of 43 RCTs involving 5017 participants were included in the systematic review and 28 RCTs encompassing 14 types of surgical interventions were included in the NMA. For improving physical function (scale 0-100), endoscopic-assisted laminotomy (mean difference: - 8.61, 95% confidence interval: - 10.52 to - 6.69; moderate-quality evidence), laminectomy combined with Coflex (- 8.41, - 13.21 to - 3.61; moderate quality evidence), and X-stop (- 6.65, - 8.60 to - 4.71; low-quality evidence) had small effects at short-term follow-up; no statistical difference was observed at mid-term follow-up (very low- to low-quality evidence); at long-term follow-up, endoscopic-assisted laminotomy (- 7.02, - 12.95 to - 1.08; very low-quality evidence) and X-stop (- 10.04, - 18.16 to - 1.93; very low-quality evidence) had a small and moderate effect, respectively. Compared with laminectomy, endoscopic-assisted laminotomy was associated with fewer adverse events due to any reason (odds ratio: 0.27, 0.09 to 0.86; low-quality evidence).
conclusionsFor adults with degenerative LSS, endoscopic-assisted laminotomy may be the safest and most effective intervention in improving physical function. However, the available data were insufficient to indicate whether the effect was sustainable after 6 months.
trial registrationPROSPERO (CRD42018094180).
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