Percutaneous endoscopic decompression for lumbar spinal stenosis: Protocol for a systematic review and network...

Area of Science:

• Neurosurgery
• Orthopedics
• Evidence Synthesis

Background:

• Lumbar spinal stenosis (LSS) is a prevalent condition requiring effective treatment.
• Percutaneous endoscopic decompression (PED) is an intervention for LSS, but its comparative effectiveness and safety are not well-established.
• A comprehensive evidence synthesis is needed to guide treatment decisions for LSS.

Purpose of the Study:

• To conduct a network meta-analysis (NMA) comparing percutaneous endoscopic decompression (PED) with other treatments for lumbar spinal stenosis (LSS).
• To evaluate the relative efficacy and safety of various interventions for LSS based on direct and indirect evidence.

Main Methods:

• Systematic search of multiple databases (Cochrane Library, PubMed, Web of Science, Embase, CBM) from inception to April 2019.
• Inclusion of all randomized controlled trials (RCTs) with risk of bias assessment.
• Network meta-analysis using R software and pairwise meta-analysis using Stata software; GRADE approach for evidence quality assessment.

Main Results:

• Efficacy outcomes include Back and Leg Visual Analog Scale (VAS) scores, MacNab criteria, Oswestry Disability Index (ODI), and Japanese Orthopedic Association (JOA) score.
• Safety outcomes encompass the incidence of complications such as dura tear, incomplete decompression, and reoperation.
• Results will be submitted for peer-reviewed publication.

Conclusions:

• The network meta-analysis will offer a thorough summary of evidence regarding treatments for LSS patients.
• Findings will aid clinicians in selecting optimal interventions for lumbar spinal stenosis.
• This study aims to clarify the comparative effectiveness and safety of PED and other LSS treatments.