Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis

Fernandez, Matthew; Ferreira, Manuela L; Refshauge, Kathryn M.; Hartvigsen, Jan; Silva, Isabela R. C.; Maher, Christopher G.; Koes, Bart W.; Ferreira, Paulo H.

doi:10.1007/s00586-015-4148-y

Cited by 28 publications

(25 citation statements)

References 68 publications

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“…A PEDro score of 7 or greater was considered of 'high quality', studies with a score of 5 or 6 were considered of 'moderate quality' and those with a score of 4 or less were deemed of 'poor quality'. [21][22][23] Any disagreements in the scoring of trials were resolved consensually. Methodological quality was not an inclusion criterion.…”

Section: Data Extraction and Risk Of Bias Assessmentmentioning

confidence: 99%

Resistance training reduces systolic blood pressure in metabolic syndrome: a systematic review and meta-analysis of randomised controlled trials

et al. 2016

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AimTo evaluate the effects of resistance training on metabolic syndrome risk factors through comparison with a control group.DesignMeta-analysis comparing resistance training interventions with control groups. Two independent reviewers selected the studies and assessed their quality and data. The pooled mean differences between resistance training and the control group were calculated using a fixed-effects model.Data sourcesThe MEDLINE, PEDro, EMBASE, SPORTDiscus and The Cochrane Library databases were searched from their earliest records to 10 January 2015.Eligibility criteria for selecting studiesRandomised controlled trials that compared the effect of resistance training on metabolic syndrome risk factors with a control group were included. All types of resistance training, irrespective of intensity, frequency or duration, were eligible.ResultsOnly systolic blood pressure was significantly reduced, by 4.08 mm Hg (95% CI 1.33 to 6.82; p<0.01), following resistance training. The pooled effect showed a reduction of 0.04 mmol/L (95% CI −0.12, 0.21; p>0.05) for fasting plasma glucose, 0.00 (95% CI −0.05, 0.04; p>0.05) for high-density lipoprotein (HDL) cholesterol, 0.03 (95% CI −0.14, 0.20; p>0.05) for triglycerides, 1.39 mm Hg (95% CI −0.19, 2.98; p=0.08) for diastolic blood pressure and 1.09 cm (95% CI −0.12, 2.30; p=0.08) for waist circumference. Inconsistency (I2) for all meta-analysis was 0%.ConclusionsResistance training may help reduce systolic blood pressure levels, stroke mortality and mortality from heart disease in people with metabolic syndrome.Trial registration numberCRD42015016538.

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Section: Data Extraction and Risk Of Bias Assessmentmentioning

confidence: 99%

Resistance training reduces systolic blood pressure in metabolic syndrome: a systematic review and meta-analysis of randomised controlled trials

et al. 2016

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“…Fig. 1 presents a flowchart of the selection process, and the results are summarized in Table 2 [ 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two SRs involving a short-term follow-up showed that surgery, including decompression with or without fusion, provided better outcomes for radiculopathy than physical activity [ 27 28 ]. When open discectomy and microscopic discectomy were compared, there was moderate-quality evidence pertaining to minimally invasive discectomy resulting in a longer duration of surgery, equal length of hospital stay, and a statistically significant but clinically irrelevant improvement in the intensity of lower leg pain.…”

Section: Resultsmentioning

confidence: 99%

“…Three high-quality SRs and one RCT showed that surgery, including decompression with or without fusion, provided better clinical outcomes for spondylolisthesis and spinal stenosis than physical activity at the short-term and long-term follow-ups and at a follow-up after more than 2 years [ 27 28 29 30 ]. One RCT compared the effect of an interspinous process device (X-Stop) with that of minimally invasive decompression in patients with neurogenic intermittent claudication due to lumbar spinal stenosis, demonstrating no significant clinical differences between them in terms of pain relief or functional improvement, although the interspinous process device posed a significantly higher risk of secondary surgery [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

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Neuropathic Pain Related with Spinal Disorders: A Systematic Review

et al. 2017

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Systematic literature review. To review the evidence from high-quality studies regarding the treatment of neuropathic pain originating specifically from spinal disorders. In general, treatment guidelines for neuropathic pain cover all its various causes, including medical disease, peripheral neuropathy, and cancer. However, the natural history of neuropathic pain originating from spinal disorders may differ from that of the pain originating from other causes or lesions. An expert research librarian used terms related to neuropathic pain and spinal disorders, disc herniation, stenosis, and spinal cord injury to search in MEDLINE, Embase, and Cochrane CENTRAL for primary research from January 2000 to October 2015. Among 2,313 potential studies of interest, 25 randomized controlled trials (RCTs) and 21 systematic reviews (SRs) were included in the analysis. The selection was decided based on the agreement of two orthopedic surgeons. There was a lack of evidence about medication for radiculopathy arising from disc herniation and stenosis, but intervention procedures, including epidural block, showed positive efficacy in radiculopathy and also limited efficacy in spinal stenosis. There was some evidence based on the short-term follow-up regarding surgery being superior to conservative treatments for radiculopathy and stenosis. There was limited evidence regarding the efficacy of pharmacological and electric or magnetic stimulation therapies for neuropathic pain after spinal cord injury. This review of RCTs and SRs with high-quality evidence found some evidence regarding the efficacy of various treatment modalities for neuropathic pain related specifically to spinal disorders. However, there is a need for much more supportive evidence.

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“…Previous systematic reviews have evaluated different treatment modalities for sciatica, including surgical and non-surgical approaches,1 epidural steroids,2 analgesic drugs,3 and advice and exercise 4. However, no previous systematic review has been published regarding the effectiveness of acupuncture for sciatica.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture for sciatica and a comparison with Western Medicine (PEDro synthesis)

Fernandez

Ferreira

2016

Br J Sports Med

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Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis

Cited by 28 publications

References 68 publications

Resistance training reduces systolic blood pressure in metabolic syndrome: a systematic review and meta-analysis of randomised controlled trials

Resistance training reduces systolic blood pressure in metabolic syndrome: a systematic review and meta-analysis of randomised controlled trials

Neuropathic Pain Related with Spinal Disorders: A Systematic Review

Acupuncture for sciatica and a comparison with Western Medicine (PEDro synthesis)

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