Spinal implants in patients with therapy-resistant pain and/or neurological symptoms

Ewald H, Glinz D, Gloy V, van Stiphout J, Raatz H
Record ID 32018000312
Authors' objectives: The aim of the current Health Technology Assessment (HTA) report is to systematically review the evidence on the clinical effectiveness and safety of disc prostheses in the cervical and lumbar spine and of interspinous or pedicle-based stabilisation in patients with degenerative changes of the lumbar spine either compared to direct decompression only or to fusion.
Authors' results and conclusions: Though the overall quality of the evidence is similar for all PICO-questions, considerably more studies were identified for PICO 4 and PICO 5 than for PICO 1, 2 and 3. Major limitations of the quality of the evidence included risk of bias, unexplained heterogeneity (inconsistency) and imprecision. The evaluation of the quality of the evidence should be re-considered in the context of decision making where values and preferences regarding aspects like the balance of benefit and harm, and costs can affect the appraisal of the available evidence and its quality.
Authors' methods: This systematic review covers five different research questions with varying populations, interventions, comparisons and outcomes (PICO). A literature search was performed in PubMed. The literature was screened and extracted by two reviewers with the second reviewer checking the extraction of the first. The assessment of the risk of bias was performed according to the Cochrane Handbook for Interventions and the quality of the evidence was evaluated according to GRADE.
Project Status: Completed
Year Published: 2016
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Switzerland
MeSH Terms
  • Lumbar Vertebrae
  • Spinal Diseases
  • Osteoarthritis, Spine
  • Intervertebral Disc Degeneration
  • Back Pain
  • Outcome Assessment, Health Care
  • Spinal Fractures
  • Prostheses and Implants
  • Kyphoplasty
  • Spine
  • Patient Reported Outcome Measures
  • Cost-Benefit Analysis
  • PROMs
  • efficacy
  • effectiveness
  • safety
  • costs
  • economics
  • cost-effectiveness
  • budget impact
  • legal
  • social
  • ethical
  • organisational
  • spinal implants
Organisation Name: Swiss Federal Office of Public Health (FOPH)
Contact Address: Federal Office of Public Health, Schwarzenburgstrasse 157, CH-3003 Berne, Switzerland
Contact Name: Stephanie Vollenweider
Contact Email: hta@bag.admin.ch
Copyright: Swiss Federal Office of Public Health
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.