Peripheral Nerve Stimulation for Low Back Pain: A Systematic Review

D’Souza, Ryan S; Jin, Max Y.; Abd‐Elsayed, Alaa

doi:10.1007/s11916-023-01109-2

Cited by 7 publications

(1 citation statement)

References 44 publications

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“…These findings are concerning because MAs are often used to guide clinical decisions and direct practice guidelines because they are considered to be the highest level of evidence. 7 Furthermore, given that the quality of evidence from many trials in the neuromodulation literature is already considered low [39][40][41][42][43][44] pooling low-quality trials within low-quality MA likely further compounds poor-quality evidence and compromises accurate data representation.…”

Section: Evidence Summarymentioning

confidence: 99%

Methodological and statistical characteristics of meta-analyses on spinal cord stimulation for chronic pain: a systematic review

Kleppel,

Copeland,

Hussain

et al. 2024

Reg Anesth Pain Med

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BackgroundA growing number of meta-analyses (MA) have investigated the use of spinal cord stimulation (SCS) as a treatment modality for chronic pain. The quality of these MAs has not been assessed by validated appraisal tools.ObjectiveTo examine the methodological characteristics and quality of MAs related to the use of SCS for chronic pain syndromes.Evidence reviewAn online literature search was conducted in Ovid MEDLINE(R), Ovid EMBASE, Ovid Cochrane Database of Systematic Reviews, and Scopus databases (January 1, 2000 through June 30, 2023) to identify MAs that investigated changes in pain intensity, opioid consumption, and/or physical function after SCS for the treatment of chronic pain. MA quality was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) critical appraisal tool.FindingsTwenty-five MAs were appraised in the final analysis. Three were considered “high” quality, three “low” quality, and 19 “critically low” quality, per the AMSTAR-2 criteria. There was no association between the publication year and AMSTAR-2 overall quality (β 0.043; 95% CI −0.008 to 0.095; p=0.097). There was an association between the impact factor and AMSTAR-2 overall quality (β 0.108; 95% CI 0.044 to 0.172; p=0.002), such that studies published in journals with higher impact factors were associated with higher overall quality. There was no association between the effect size and AMSTAR-2 overall quality (β −0.168; 95% CI −0.518 to 0.183; p=0.320).According to our power analysis, three studies were adequately powered (>80%) to reject the null hypothesis, while the remaining studies were underpowered (<80%).ConclusionsThe study demonstrates a critically low AMSTAR-2 quality for most MAs published on the use of SCS for treating chronic pain. Future MAs should improve study quality by implementing the AMSTAR-2 checklist items.PROSPERO registration numberCRD42023431155.

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