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European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Jan, 2024;33 (1): 264-273.

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

Lauren M Nielsen, Emily N Getz, Jodi L Young, Daniel I Rhon
Author Information
  1. Lauren M Nielsen: Doctor of Science in Physical Therapy Program, Bellin College, Eaton Road, Green Bay, WI, 54311, USA. lauren.nielsen@bellincollege.edu. ORCID
  2. Emily N Getz: Doctor of Science in Physical Therapy Program, Bellin College, Eaton Road, Green Bay, WI, 54311, USA.
  3. Jodi L Young: Doctor of Science in Physical Therapy Program, Bellin College, Eaton Road, Green Bay, WI, 54311, USA.
  4. Daniel I Rhon: Doctor of Science in Physical Therapy Program, Bellin College, Eaton Road, Green Bay, WI, 54311, USA.
PMID: 37803158 DOI: 10.1007/s00586-023-07926-8

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.
CONCLUSION: 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.

Keywords

Arthrodesis Conservative care Lumbar fusion Spinal fusion

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MeSH Term

Adult
Humans
Conservative Treatment
Spinal Fusion
Preoperative Care
Randomized Controlled Trials as Topic
Journal Article Review
Article has an altmetric score of 3

Word Cloud

Created with Highcharts 10.0.0conservativecarefusiontrialslumbartreatmentpre-surgicalreportedreviewstudiespriorprovidedrandomizedcontrolledtypescoping15interventiondetailsdecision-makingclinicalPURPOSE:identifycharacterizedadultsundergoingelectiveincludingdurationMETHODS:studydesignDatasourcesincludePubMedCumulativeIndexNursingAlliedHealthLiteratureCINAHLOvidMedlineEMBASECochraneCentralRegisterControlledTrialsCENTRALpublishedEnglishJanuary12005February2022assessingincludedRESULTS:166620%failure1%detailedspecificcare receivedNonesufficientunderstandnaturefrequencyrecency/timingdosageinterventionsCONCLUSION:Althoughroughlytwo-thirdsthat patientsfailedreceivingnamedregardingdosingrecencylackinformationcreatesambiguitysurgicalprocesssettingassumptionpatientsreceivedadequatesurgeryDetailsdisclosedallowappropriateapplicationinterpretationeffectsPreoperativeinsufficientlydescribedfusion:ArthrodesisConservativeLumbarSpinal

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