TABLE 174Summary of the overall findings of the standard pair-wise analyses

ComparisonShort-term follow-upMedium-term follow-upLong-term follow-upAdverse effects
Global effectPain intensityCSOMsGlobal effectPain intensityCSOMsGlobal effectPain intensityCSOMs
Disc surgery vs usual care+++<>+<><>
Disc surgery vs epidural+<><>
Disc surgery vs non-opioids<><><>
Disc surgery vs disc surgery and non-opioids<>
Disc surgery plus exercise therapy vs exercise therapy<>+<><><><><><><><>
Disc surgery vs disc surgery and acupuncture
Disc surgery vs intraoperative interventions<><><><><><><><>
Disc surgery vs chemonucleolysis<><><><><><>+ (marginal)<><><>
Disc surgery vs disc surgery and chemonucleolysis<><><>
Epidural vs inactive control<>++<><><><><><><>
Epidural vs usual care+<>+<><><>
Epidural vs non-opioids++<><><>
Epidural vs epidural and non-opioids<><><><>
Epidural vs chemonucleolysis<><>
Epidural vs passive PT+<><>+<>+
Epidural vs activity restriction+<>
Epidural vs acupuncture<><>
Epidural vs biological agents<><><>
Physiotherapy vs physiotherapy and epidural
Chemonucleolysis vs inactive control<><>+<><><>
Chemonucleolysis vs manipulation<><><><><>
Non-opioids vs inactive control++<><>+<>
Non-opioids vs opioids<>+<>
Non-opioids vs acupuncture+<>
Non-opioids vs biological agents
Traction vs inactive control<><><><><><>
Traction vs usual care<><>
Traction vs exercise therapy<>
Traction vs passive PT<><><><><><>
Exercise therapy vs exercise therapy and traction<><><><><>
Passive PT vs passive PT and traction<>
Activity restriction vs activity restriction and traction<><>+
Manipulation vs inactive control<>+
Alternative interventions vs inactive control+
Exercise therapy vs activity restriction<>
Exercise therapy vs usual care<><><><>+<><>
Exercise therapy vs inactive control+
Activity restriction vs manipulation and exercise therapy<><><><>
Passive PT vs inactive control++
Biological agents vs inactive control++<>+<><>
Activity restriction vs education/advice<><><><><><>
Opioids vs inactive control<><><>
Opioids vs opioids and non-opioids<><><>

<>, no statistically significant difference between the intervention groups; +, statistically significant findings in favour of the intervention group; −, statistically significant findings in favour of the control group.

The CIs of the OR for the meta-analysis comparing disc surgery to chemonucleolysis touched, but did not cross the line of no effect (OR 1.44, 95% CI 1.00 to 2.09) and was therefore considered marginally statistically significant.

From: 10, Discussion

Cover of The Clinical Effectiveness and Cost-Effectiveness of Management Strategies for Sciatica: Systematic Review and Economic Model
The Clinical Effectiveness and Cost-Effectiveness of Management Strategies for Sciatica: Systematic Review and Economic Model.
Health Technology Assessment, No. 15.39.
Lewis R, Williams N, Matar HE, et al.
Southampton (UK): NIHR Journals Library; 2011 Nov.
© 2011, Crown Copyright.

Included under terms of UK Non-commercial Government License.

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