AUTHOR=Chen Xuanwei , Zheng Zhizhan , Lin Jianhua 

TITLE=Clinical Effectiveness of Conservative Treatments on Lumbar Spinal Stenosis: A Network Meta-Analysis

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.859296

DOI=10.3389/fphar.2022.859296

ISSN=1663-9812

ABSTRACT=Objective: To systematically evaluate the clinical effectiveness of conservative treatments including pharmacological treatments and non-pharmacological treatments on patients with lumbar spinal stenosis. Methods: We searched six electronic databases systematically for randomized clinical trials published between 2000.1 and 2021.7, including the China National Knowledge Infrastructure, WanFang Data, PubMed, MEDLINE, Embase and Cochrane library. Studies focused on the therapeutic effects of pharmacological treatments including calcitonin, antiepileptics, neurotrophic drugs, non-steroidal anti-inflammatory drugs, Chinese Traditional Medicine, limaprost and non-pharmacological treatments like physiotherapy on treating lumbar spinal stenosis were included. The outcome measures were visual analogue scale, Oswestry Dysfunction Index, Japanese Orthopaedic Association Score and EuroQol Five Dimensions Questionnaire. The quality of eligible studies was assessed by using the Cochrane recommended bias risk assessment tool. Stata was used to conduct the network meta-analysis. Results: A total of 12 randomized control trials with 1 194 patients were included. The network meta-analysis showed that for visual analogue scale, better therapeutic effect was noted in using Chinese Traditional Medicine and physiotherapy, then followed with analgesics drugs and limaprost. Limaprost and calcitonin were better in decreasing Oswestry Dysfunction Index. In terms of Japanese Orthopaedic Association Score, the use of traditional Chinese Medicine and limaprost were associated with a better improvement than other treatments. Meanwhile, limaprost combined with analgesics drugs was found to be effective to improve the EuroQol Five Dimensions Questionnaire. Conclusion: Among the commonly used conservative treatments for the treatment of lumbar spinal stenosis, limaprost may have better efficacy in improving Japanese Orthopedic Association Score and decreasing Oswestry Dysfunction Index, with a beneficial effect on decreasing visual analogue scale and improving EuroQol Five Dimensions Questionnaire.