caa a22 4500 445832975 CHVBK 20180317145321.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s00586-011-1873-8 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1873-8 Effectiveness of interspinous implant surgery in patients with intermittent neurogenic claudication: a systematic review and meta-analysis [Elektronische Daten] [Wouter Moojen, Mark Arts, Ronald Bartels, Wilco Jacobs, Wilco Peul] Introduction: Despite an increasing implantation rate of interspinous process distraction (IPD) devices in the treatment of intermittent neurogenic claudication (INC), definitive evidence on the clinical effectiveness of implants is lacking. The main objective of this review was to perform a meta-analysis of all systematic reviews, randomized clinical trials and prospective cohort series to quantify the effectiveness of IPDs and to evaluate the potential side-effects. Methods: Data from all studies prospectively describing clinical results based on validated outcome scales and reporting complications of treatment of patients with INC with IPD placement. We searched MEDLINE, EMBASE, Web of Science, Cochrane (CENTRAL), CINAHL, Academic Search Premier, Science Direct up to July 2010. Studies describing patients with INC caused by lumbar stenosis, reporting complication rate and reporting based on validated outcome scores, were eligible. Studies with only instrumented IPD results were excluded. Results: Eleven studies eligible studies were identified. Two independently RCTs and eight prospective cohorts were available. In total 563 patients were treated with IPDs. All studies showed improvement in validated outcome scores after 6weeks and 1year. Pooled data based on the Zurich Claudication Questionnaire of the RCTs were more in favor of IPD treatment compared with conservative treatment (pooled estimate 23.2, SD 18.5-27.8). Statistical heterogeneity after pooled data was low (I-squared 0.0, p=0.930). Overall complication rate was 7%. Conclusion: As the evidence is relatively low and the costs are high, more thorough (cost-) effectiveness studies should be performed before worldwide implementation is introduced. The Author(s), 2011 Degenerative nationallicence Lumbar spinal nationallicence Stenosis nationallicence IPD nationallicence Effectiveness nationallicence Meta-analysis nationallicence Complications nationallicence Moojen Wouter Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands aut Arts Mark Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands aut Bartels Ronald Department of Neurosurgery, University Medical Hospital, Nijmegen, The Netherlands aut Jacobs Wilco Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands aut Peul Wilco Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands aut European Spine Journal Springer-Verlag 20/10(2011-10-01), 1596-1606 0940-6719 20:10<1596 2011 20 586 https://doi.org/10.1007/s00586-011-1873-8 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1873-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Moojen Wouter Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands aut NATIONALLICENCE 700 1- Arts Mark Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands aut NATIONALLICENCE 700 1- Bartels Ronald Department of Neurosurgery, University Medical Hospital, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Jacobs Wilco Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands aut NATIONALLICENCE 700 1- Peul Wilco Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/10(2011-10-01), 1596-1606 0940-6719 20:10<1596 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer