title: Interspinous process devices(IPD) alone versus decompression surgery for lumbar spinal stenosis(LSS): A systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  and purpose: Interspinous process devices (IPD) were widely used for the treatment of lumbar spinal stenosis (LSS). However, whether IPD was superior to bony decompression was still debated. We aimed to compare the clinical outcomes of IPD to bony decompression for LSS.
  
  
  METHODS
  PubMed, Cochrane library, Cochrane Central Register of Controlled Trials (CCTR), Ovid Medline, China national knowledge internet database, Wan Fang database were searched in August.8th.2016. Studies were identified using selection criteria and analysed was performed with Review Manager Version 5.3.
  
  
  RESULTS
  Four RCTs (seven articles) were included, with 200 patients in the interspinous process devices (IPD) group and 200 patients in bony decompression (DP) group. There was no significant difference in hospital stay time (P = 0.36), VAS leg pain scores (P = 0.83), and complication rates (P = 0.20) for IPD alone versus bony decompression. However, IPD alone showed higher VAS low back pain scores (P = 0.03) and reoperation rates (P < 0.0001) between the two therapy groups. Two studies' results showed the IPD group had lower cost-effectiveness.
  
  
  CONCLUSIONS
  Although patients who received IPD may obtain several benefits in the short term, it was associated with higher costs, reoperation rates. Both IPD and bony decompression were acceptable strategies for LSS, but the risks, indications, and costs of IPD should be carefully taken into account before surgery.
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Tianjin Medical University, Tianjin 30070, People's Republic of China. Electronic address: longlongwin@sina.cn.
authors.forename: Xing-Wen
authors.initials: XW
authors.lastname: Zhao
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China. Electronic address: 1638977822@qq.com.
authors.forename: Jian-Xiong
authors.initials: JX
authors.lastname: Ma
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Department of Orthopaedics, Tianjin Hospital, Tianjin 300211, People's Republic of China; Tianjin Medical University, Tianjin 30070, People's Republic of China. Electronic address: 446483619@qq.com.
authors.forename: Xin-Long
authors.initials: XL
authors.lastname: Ma
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Tianjin Medical University, Tianjin 30070, People's Republic of China.
authors.forename: Fei
authors.initials: F
authors.lastname: Li
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Tianjin Medical University, Tianjin 30070, People's Republic of China.
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: He
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Department of Orthopaedics, Tianjin Hospital, Tianjin 300211, People's Republic of China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Tianjin Medical University, Tianjin 30070, People's Republic of China.
authors.forename: Biao
authors.initials: B
authors.lastname: Han
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology*; D016032:Randomized Controlled Trials as Topic; D012086:Reoperation; D013130:Spinal Stenosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Bony decompression (DP); Interspinous process devices (IPD); Laminectomy; Lumbar spinal stenosis(LSS); Randomized controlled trials (RCTs); Systematic review and meta-analysis