AI Article Synopsis
- Chronic low back pain (CLBP) is linked to motor control issues and degeneration of the lumbar multifidus muscles, with studies suggesting that multifidus stimulation might help alleviate pain.
- A systematic review of six studies with 419 participants showed an average pain reduction of 2.9 units on a 0-10 scale, indicating a significant positive effect of the treatment.
- The analysis found that longer follow-up times were correlated with greater reductions in pain, suggesting that sustained stimulation benefits CLBP patients more effectively.
Article Abstract
Introduction: Chronic low back pain (CLBP) is often associated with impaired motor control and degeneration of the lumbar multifidus muscles. Several studies have reported on the utility of multifidus or medial branch stimulation as a treatment. We present a systematic review and meta-analysis of studies reporting on the change in low back pain intensity with multifidus stimulation.
Materials And Methods: A comprehensive literature search was conducted from 2010 to 2022 for randomized controlled trials or prospective reports in adults with CLBP, treated with multifidus or medial nerve stimulation through implanted or percutaneous device. Mean change (standard error) in pain intensity was extracted and data synthesized using a mixed effects regression with a random intercept for the study to account for repeated time points.
Results: A total of 419 participants were enrolled in six studies; there were 25 effects (one to six time points per study), with follow-ups ranging from 1.5 to 48 months. The weighted pooled mean effect was a reduction in pain intensity (0-10 scale) of 2.9 units (95% CI: 2.1-3.7). The 95% prediction interval was a reduction in pain intensity of 0.6 to 5.2 units. The estimated probability of a reduction in pain of >two units in a new similar study is 0.84 (0.68-0.98). Meta-regression revealed that a longer follow-up time was associated with greater reductions in pain (0.25 units [0.16-0.34] per six months).
Conclusions: Medial branch stimulation for the treatment of CLBP shows a high probability of a clinically significant change in pain intensity. Longer duration of stimulation was associated with decreased low back pain intensities.
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| http://dx.doi.org/10.1016/j.neurom.2024.08.002 | DOI Listing |
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