Evidence map›Paper›PMID 34988710›Full record

SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2022

Simultaneous decompression of all stenotic regions versus decompression of only the most symptomatic region in patients with tandem spinal stenosis: a systematic review and meta-analysis.

Samarth Mittal, Kaustubh Ahuja, P V Sudhakar, Syed Ifthekar, Gagandeep Yadav, Bhaskar Sarkar, Pankaj Kandwal

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. [ Symptomatic Triple-Region Spinal Stenosis (TRSS): case report and narrative Literature Review]Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2024
    Review
  3. Radiographic predictors for recurrence of lumbar symptoms after prioritized cervical surgery in patients with tandem spinal stenosis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Samarth MittalAIIMS Rishikesh, Rishikesh, Uttarakhand, 249203, India.
Kaustubh AhujaAIIMS Rishikesh, Rishikesh, Uttarakhand, 249203, India.
P V SudhakarAIIMS Rishikesh, Rishikesh, Uttarakhand, 249203, India.
Syed IfthekarAIIMS Rishikesh, Rishikesh, Uttarakhand, 249203, India.
Gagandeep YadavAIIMS Rishikesh, Rishikesh, Uttarakhand, 249203, India.
Bhaskar SarkarAIIMS Rishikesh, Rishikesh, Uttarakhand, 249203, India.
Pankaj KandwalDepartment of Orthopaedics, AIIMS Rishikesh, Rishikesh, Uttarakhand, 249203, India. pankaj.orth@aiimsrishikesh.edu.in.ORCID 0000-0002-8801-6909

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSelection of anatomic region of spine for decompression in patients with symptomatic tandem spinal stenosis (TSS) remains a challenge due to the confusing clinical presentation as well as uncertain evidence. A systematic review and meta-analysis of observational studies were conducted to compare the outcomes between simultaneous decompression of all stenotic regions (cervical and lumbar, Group 1) and decompression of only the most symptomatic stenotic region (cervical/lumbar, Group 2) in patients with TSS.

methodsA systematic review was conducted, and a comprehensive literature search with well-established inclusion and exclusion criteria with JOA score as an outcome measure was done on PubMed, Google Scholar, and EMBASE database (till January 2021). Observational studies reporting outcomes after simultaneous decompression or only the most symptomatic region were included. NIH quality assessment tool was used to check the quality of each study, and treatment effects were calculated using Dersimonian and Laird random effects model.

resultsTen studies were included in the analysis out of which all were retrospective observational studies (Level 4 evidence) except one (Level 3 evidence). Overall proportional meta-analysis showed no significant difference in change in JOA scores, operative time, blood loss, total and major complications between Group 1 and Group 2. However, minor complications were significantly increased on performing decompression of both regions simultaneously (p = 0.04). On performing subgroup analysis comparing cervical surgery cohort with lumbar surgery cohort, no difference was found in change in JOA score and requirement of second-stage surgery.

conclusionDecompression of the most symptomatic region alone irrespective of its location has equal clinical outcomes with less complication rate than simultaneous decompression in patients with TSS.

Indexed as

Spinal StenosisCervical VertebraeDecompression, SurgicalHumansLumbar VertebraeRetrospective StudiesTreatment OutcomeCervical stenosisConcurrent spinal stenosisLumbar stenosisMeta-analysesSimultaneous decompressionTandem spinal stenosis

Identifiers

PMID34988710

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.