The effectiveness of therapeutic strategies for patients with radiculopathy: A network meta-analysis

Zhang, Xiaoyu; Zhang, Zhi‐Qiang; Wen, Jianzhong; Lu, Jie; Sun, Yingchun; Sang, Dechun

doi:10.1177/1744806918768972

Cited by 24 publications

(14 citation statements)

References 41 publications

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“…Our results are in same direction of the systematic reviews of Cheng [ 41 ] and Zhang [ 39 ]. The first one [ 41 ] showed short-term results in favor of traction for the treatment of LBP with herniated intervertebral disks, but this review included studies on patients with and without LR.…”

Section: Discussionsupporting

confidence: 87%

“…Therefore, we conclude that the role of VT appears very limited in LR, since positive results were found only on pain and only when it was compared to medications or bed rest. Relative to the effects of medications in LR, there are conflicting conclusions on NSAIDs among who considered them as effective [ 8 ], who did not draw conclusions [ 6 ], and who did not recommend them [ 37 , 38 ], while a recent systematic review suggested that corticosteroids were effective in LR [ 39 ]. Concerning the advice of bed rest or stay active in patients with sciatica, little or no difference emerged on pain and function, with moderate quality evidence [ 6 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

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Vertical traction for lumbar radiculopathy: a systematic review

et al. 2021

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Background Only low-quality evidence is currently available to support the effectiveness of different traction modalities in the treatment of lumbar radiculopathy (LR). Yet, traction is still very commonly used in clinical practice. Some authors have suggested that the subgroup of patients presenting signs and symptoms of nerve root compression and unresponsive to movements centralizing symptoms may benefit from lumbar traction. The aim of this study is to conduct a systematic review of randomized controlled trials (RCTs) on the effects of vertical traction (VT) on pain and activity limitation in patients affected by LR. Methods We searched the Cochrane Controlled Trials Register, PubMed, CINAHL, Scopus, ISI Web of Science and PEDro from their inception to March 31, 2019 to retrieve RCTs on adults with LR using VT to reduce pain and activity limitation. We considered only trials reporting complete data on outcomes. Two reviewers selected the studies, extracted the results, and performed the quality assessment using the Risk of Bias and GRADE tools. Results Three studies met the inclusion criteria. Meta-analysis was not possible due to the heterogeneity of the included studies. We found very low quality evidence for a large effect of VT added to bed rest when compared to bed rest alone (g = − 1.01; 95% CI = -2.00 to − 0.02). Similarly, VT added to medication may have a large effect on pain relief when compared to medication alone (g = − 1.13; 95% CI = -1.72 to − 0.54, low quality evidence). Effects of VT added to physical therapy on pain relief were very small when compared to physical therapy without VT (g = − 0.14; 95% CI = -1.03 to 0.76, low quality evidence). All reported effects concerned short-term effect up to 3 months post-intervention. Conclusions With respect to short-term effects, VT may have a positive effect on pain relief if added to medication or bed rest. Long-term effects of VT are currently unknown. Future higher quality research is very likely to have an important impact on our confidence in the estimate of effect and may change these conclusions.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Vertical traction for lumbar radiculopathy: a systematic review

et al. 2021

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“…This is because the traditional pairwise meta‐analysis can only achieve direct comparison between the two interventions and cannot comprehensively evaluate the efficacy of various interventions. Network meta‐analysis is an extension of traditional pairwise meta‐analysis to multiple treatment comparisons and is a good choice when there is a lack of direct evidence, because it allows indirect comparisons between different types of treatment …”

Section: What Is Known and Objectivementioning

confidence: 99%

“…Network meta-analysis is an extension of traditional pairwise meta-analysis to multiple treatment comparisons and is a good choice when there is a lack of direct evidence, because it allows indirect comparisons between different types of treatment. 29,30 Therefore, this study used Bayesian network meta-analysis to systematically evaluate the efficacy of CHIs for the treatment of mycoplasma pneumonia in children and obtain the ranking of their effect in different outcomes, to provide evidence of evidence-based medicine for the clinicians to choose a more suitable therapy.…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

Comparative efficacy of Chinese herbal injections combined with azithromycin for mycoplasma pneumonia in children: A Bayesian network meta‐analysis of randomized controlled trials

Duan

Wang

et al. 2019

J Clin Pharm Ther

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What is known and objectiveAn increasing macrolide resistance leads to complex clinical treatment schemes in mycoplasma pneumonia in children. Chinese herbal injection (CHI) is widely used to treat it and may provide a new treatment regimen. This study was conducted to systematically evaluate the efficacy of CHIs combined with azithromycin for treating mycoplasma pneumonia in children by Bayesian network meta‐analysis.MethodsRandomized controlled trials (RCTs) of CHIs combined with azithromycin for mycoplasma pneumonia in children were searched in electronic databases and related references from initiation to 30 October 2018. Two researchers conducted data extraction and risk of bias assessment. WinBUGS software and STATA software were adopted to analyse the data.ResultsA total of 167 RCTs were included with 5 CHIs involving 16 144 patients. All CHIs combined with azithromycin had superior effects than azithromycin only among overall outcomes. Yanhuning injection combined with azithromycin ranked highest in four different outcomes and second in two based on surface under the cumulative ranking probabilities (SUCRA). Meanwhile, the results of MD and 95% CIs of concerned outcomes indicated that only Yanhuning injection combined with azithromycin had better response than other CHIs combined with azithromycin. Moreover, cluster analysis results revealed Reduning injection combined with azithromycin was associated with a positive effect on the three group outcomes. Similarly, it was found to be the top three ranking in all outcomes based on SUCRA.What is new and conclusionYanhuning injection combined with azithromycin and Reduning injection combined with azithromycin were found to be preferable treatments based on the data of this study.

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“…Available treatment options are broadly divided into pharmacologic, conservative, interventional and surgical (2). The Guidelines from the American Pain Society highlight that the risk-benefit analysis of invasive therapies in this condition is controversial and therefore, advises that it is more reasonable to first consider conservative management that focuses on appropriate pain control and functional recovery (3).…”

mentioning

confidence: 99%