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Conservative Care in Lumbar Spine Surgery Trials: A Descriptive Literature Review.

Publication ,  Journal Article
Yang, AJ; Coronado, RA; Hoffecker, L; Gao, C; Saurwein, K; Shoreman, D; Hoffberg, AS; Akuthota, V
Published in: Arch Phys Med Rehabil
January 2017

OBJECTIVE: To evaluate the degree to which conservative care and failure were specifically defined in studies comparing nonoperative treatment versus surgery for low back pain (LBP) conditions in adults. DATA SOURCES: A comprehensive literature search was conducted by an experienced librarian using MEDLINE (PubMed), Embase, Google Scholar, and CENTRAL from January 2003 to June 2014. Endnote bibliographic management application was used to remove duplicates and organize the citations. STUDY SELECTION: Prospective, randomized, or cohort trials comparing surgery versus conservative intervention for patients with LBP conditions. Study selection was conducted by 2 independent reviewers. DATA EXTRACTION: Three independent reviewers extracted data from each article using a structured data extraction form. Data extracted included type of study, participant characteristics, sample size, description, and duration of conservative care and whether failed conservative care criterion was defined. DATA SYNTHESIS: A total of 852 unique records were screened for eligibility; of those, 72 articles were identified for further full-text review. Thirty-four full texts were excluded based on the exclusion criteria, and 38 articles, representing 20 unique studies, were included for qualitative synthesis. Fifteen of the 20 studies defined the duration of conservative care. Only 3 studies defined the dosage of physical therapy sessions, including total number of visits and visit duration. Two studies described medication usage, including the duration and type. No studies specifically defined what constituted failed conservative therapy. CONCLUSIONS: This literature review suggests conservative care is poorly defined in randomized trials, which can lead to ambiguity of research procedures and unclear guidelines for clinicians. Future studies should increase transparency and explicitly define conservative care.

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Published In

Arch Phys Med Rehabil

DOI

EISSN

1532-821X

Publication Date

January 2017

Volume

98

Issue

1

Start / End Page

165 / 172

Location

United States

Related Subject Headings

  • Treatment Failure
  • Terminology as Topic
  • Spinal Diseases
  • Rehabilitation
  • Physical Therapy Modalities
  • Lumbar Vertebrae
  • Low Back Pain
  • Humans
  • Conservative Treatment
  • 4207 Sports science and exercise
 

Citation

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Yang, A. J., Coronado, R. A., Hoffecker, L., Gao, C., Saurwein, K., Shoreman, D., … Akuthota, V. (2017). Conservative Care in Lumbar Spine Surgery Trials: A Descriptive Literature Review. Arch Phys Med Rehabil, 98(1), 165–172. https://doi.org/10.1016/j.apmr.2016.07.025
Yang, Aaron J., Rogelio A. Coronado, Lilian Hoffecker, Chan Gao, Kelly Saurwein, Danielle Shoreman, Adam S. Hoffberg, and Venu Akuthota. “Conservative Care in Lumbar Spine Surgery Trials: A Descriptive Literature Review.Arch Phys Med Rehabil 98, no. 1 (January 2017): 165–72. https://doi.org/10.1016/j.apmr.2016.07.025.
Yang AJ, Coronado RA, Hoffecker L, Gao C, Saurwein K, Shoreman D, et al. Conservative Care in Lumbar Spine Surgery Trials: A Descriptive Literature Review. Arch Phys Med Rehabil. 2017 Jan;98(1):165–72.
Yang, Aaron J., et al. “Conservative Care in Lumbar Spine Surgery Trials: A Descriptive Literature Review.Arch Phys Med Rehabil, vol. 98, no. 1, Jan. 2017, pp. 165–72. Pubmed, doi:10.1016/j.apmr.2016.07.025.
Yang AJ, Coronado RA, Hoffecker L, Gao C, Saurwein K, Shoreman D, Hoffberg AS, Akuthota V. Conservative Care in Lumbar Spine Surgery Trials: A Descriptive Literature Review. Arch Phys Med Rehabil. 2017 Jan;98(1):165–172.
Journal cover image

Published In

Arch Phys Med Rehabil

DOI

EISSN

1532-821X

Publication Date

January 2017

Volume

98

Issue

1

Start / End Page

165 / 172

Location

United States

Related Subject Headings

  • Treatment Failure
  • Terminology as Topic
  • Spinal Diseases
  • Rehabilitation
  • Physical Therapy Modalities
  • Lumbar Vertebrae
  • Low Back Pain
  • Humans
  • Conservative Treatment
  • 4207 Sports science and exercise