Quality assessment of systematic reviews of surgical treatment of cervical spine degenerative diseases: an overview

Astur, Nelson; Martins, Delio Eulalio; Kanas, Michel; Mendonça, Rodrigo Góes Medéa de; Creek, Aaron T.; Lenza, Mario; Wajchenberg, Marcelo

doi:10.31744/einstein_journal/2022AO6567

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Einstein (São Paulo) 20 • 2022 • https://doi.org/10.31744/einstein_journal/2022AO6567 copy

Quality assessment of systematic reviews of surgical treatment of cervical spine degenerative diseases: an overview

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To gather all systematic reviews of surgical treatment of degenerative cervical diseases and assess their quality, conclusions and outcomes.

Methods

A literature search for systematic reviews of surgical treatment of degenerative cervical diseases was conducted. Studies should have at least one surgical procedure as an intervention. Included studies were assessed for quality through Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) and Assessment of Multiple Systematic Reviews (AMSTAR) questionnaires. Quality of studies was rated accordingly to their final score as very poor (<30%), poor (30%-50%), fair (50%-70%), good (70%-90%), and excellent (>90%). If an article reported a conclusion addressing its primary objective with supportive statistical evidence for it, they were deemed to have an evidence-based conclusion.

Results

A total of 65 systematic reviews were included. According to AMSTAR and PRISMA, 1.5% to 6.2% of studies were rated as excellent, while good studies counted for 21.5% to 47.7%. According to AMSTAR, most studies were of fair quality (46.2%), and 6.2% of very poor quality. Mean PRISMA score was 70.2%, meaning studies of good quality. For both tools, performing a meta-analysis significantly increased studies scores and quality. Cervical spondylosis studies reached highest scores among diseases analyzed. Authors stated conclusions for interventions compared in 70.7% of studies, and only two of them were not supported by statistical evidence.

Conclusion

Systematic reviews of surgical treatment of cervical degenerative diseases present “fair” to “good” quality in their majority, and most of the reported conclusions are supported by statistical evidence. Including a meta-analysis significantly increases the quality of a systematic review.

Spinal diseases; Cervical vertebrae; Chronic disease; Hernia; Intervertebral disc; Spondylosis; Orthopedic procedures

((((Zygapophyseal Joint [mh] OR Neck Pain [mh] OR cervical pain [mh] OR neck pain [tw] OR facet joint* [tw] OR cervical pain [tw] OR Intervertebral disk degeneration [mh] OR spinal stenosis [mh] OR cervical myelopathy [tw] OR myelopathy [mh] OR hernia* [tw] OR prolapse* [tw] OR extru* [tw]))) AND (((neck surgery [tw] OR Spinal fusion [mh] OR Arthrodesis [mh] OR Laminectomy [mh] Instrumentation [tw] OR Decompression, Surgical [mh] OR fusion [tw] OR in situ fusion [tw] OR interbody fusion [tw] OR disc replacement [tw] OR arthroplasty [tw])))) AND ((meta-analysis [pt] OR Systematic Reviews [tw] OR randomized controlled trial [pt] OR controlled clinical trial [pt] OR randomized controlled trials [mh] OR random allocation [mh] OR double-blind method [mh] OR single-blind method [mh] OR clinical trial [pt] OR clinical trials [mh]))

Quality tool	Mean score (%)
AMSTAR total	58.2
PRISMA total	70.2
PRISMA - Title	87.7
PRISMA - Abstract	54
PRISMA - Introduction	75
PRISMA - Methods	65
PRISMA - Results	70
PRISMA - Discussion	88.9
PRISMA - Funding	67.7

Authors	1	2	3	4	5	6	7	8	9	10	11	Total (%)
Boselie et al.,⁽⁶¹⁾		X	X	X	X	X	X	X	X	X	X	90.91
Zhong et al.,⁽⁶³⁾		X	X	X		X	X	X	X	X	X	81.82
Bartels et al.,⁽¹⁸⁾	X	X	X	X		X	X	X	X		X	81.82
Li et al.,⁽⁷⁷⁾	X	X	X			X	X	X	X	X	X	81.82
Dong et al.,⁽³⁸⁾	X	X	X	X		X	X	X	X		X	81.82
Liu et al.,⁽¹⁶⁾		X	X	X		X	X	X	X	X	X	81.82
Luo et al.,⁽³⁴⁾	X	X	X			X	X	X	X		X	72.73
Liu et al.,⁽³²⁾		X	X			X	X	X	X	X	X	72.73
Wu et al.,⁽⁶²⁾	X	X	X			X	X	X	X		X	72.73
Guan et al.,⁽³⁷⁾		X	X			X	X	X	X	X	X	72.73
Lu et al.,⁽⁶⁰⁾		X	X			X	X	X	X	X	X	72.73
Jacobs et al.,⁽⁵¹⁾		X	X	X		X	X	X	X		X	72.73
Botelho et al.,⁽²⁶⁾		X	X		X	X	X	X	X		X	72.73
Verhagen et al.,⁽²⁰⁾		X	X			X	X	X	X	X	X	72.73
Gu et al.,⁽⁴⁹⁾	X	X	X			X	X	X	X		X	72.73
Han et al.,⁽⁴⁵⁾	X	X	X			X	X	X	X			63.64
Rao et al.,⁽⁶⁴⁾		X	X				X	X	X	X	X	63.64
Yin et al.,⁽⁵⁰⁾		X	X				X	X	X	X	X	63.64
Zhang et al.,⁽³³⁾		X	X				X	X	X	X	X	63.64
Zhang et al.,⁽⁵⁸⁾		X	X			X	X	X	X		X	63.64
Hu et al.,⁽⁶⁶⁾		X	X		X	X	X	X	X			63.64
Gao et al.,⁽⁵²⁾		X			X	X	X		X	X	X	63.64
Xiao et al.,⁽⁷⁰⁾		X	X			X	X	X	X		X	63.64
Luo et al.,⁽⁴³⁾	X		X			X	X	X	X		X	63.64
Liu et al.,⁽³⁰⁾	X		X	X			X	X	X		X	63.64
Lee et al.,⁽⁵³⁾		X	X				X	X	X	X	X	63.64
van Middelkoop et al.,⁽⁷⁹⁾		X	X				X	X	X	X	X	63.64
Wang et al.,⁽⁷³⁾		X	X			X	X	X	X		X	63.64
Wang et al.,⁽²⁹⁾	X	X	X				X	X	X		X	63.64
Verma et al.,⁽⁶⁹⁾	X	X	X				X	X	X		X	63.64
Gao et al.,⁽²⁴⁾	X	X	X				X	X	X		X	63.64
Liu et al.,⁽⁴⁸⁾		X	X				X	X	X	X	X	63.64
Fei et al.,⁽²²⁾		X	X				X	X	X	X	X	63.64
Shamji et al.,⁽²¹⁾		X	X			X	X	X	X	X		63.64
Yuan et al.,⁽¹⁹⁾	X	X	X			X	X	X	X			63.64
van Middelkoop et al.,⁽⁵⁷⁾		X	X				X	X	X	X	X	63.64
Wang et al.,⁽⁷¹⁾	X	X	X				X	X	X	X		63.64
Yang et al.,⁽⁶⁸⁾	X	X	X				X	X	X			54.55
Li et al.,⁽⁷⁴⁾		X	X			X		X	X		X	54.55
Tian et al.,⁽⁴⁰⁾		X	X	X			X	X	X			54.55
Aragones et al.,⁽⁵⁶⁾	X		X			X	X	X	X			54.55
Fouyas et al.,⁽³⁶⁾	X	X	X						X	X	X	54.55
Harrod et al.,⁽²⁵⁾	X		X				X	X	X		X	54.55
Liu et al.,⁽²³⁾		X	X	X		X	X	X				54.55
Wen et al.,⁽⁷⁸⁾		X	X				X	X	X	X		54.55
Liu et al.,⁽⁷⁵⁾		X	X				X	X	X			45.45
Muheremu et al.,⁽⁷²⁾		X	X					X	X		X	45.45
Yu et al.,⁽⁵⁵⁾			X				X	X	X	X		45.45
Xing et al.⁽⁷⁶⁾				X		X			X	X	X	45.45
Fallah et al.,⁽⁴⁷⁾	X		X				X	X	X			45.45
Zhu et al.,⁽³⁹⁾		X	X					X	X		X	45.45
Cepoiu-Martin et al.,⁽⁴⁶⁾		X	X			X	X	X				45.45
Jiang et al.,⁽⁴⁴⁾	X	X	X				X		X			45.45
Ren et al.,⁽⁶⁵⁾		X	X						X	X	X	45.45
Zhao et al.,⁽⁴¹⁾		X	X				X	X	X			45.45
Sun et al.,⁽⁵⁴⁾		X	X						X	X	X	45.45
Lu et al.,⁽⁶⁰⁾		X	X				X	X		X		45.45
Huang et al.,⁽⁴²⁾						X	X	X	X			36.36
Shriver et al.,⁽³¹⁾		X				X	X		X			36.36
van Limbeek et al.,⁽²⁸⁾		X	X				X	X				36.36
Yoon et al.,⁽¹⁷⁾			X	X	X	X						36.36
Gebremariam et al.,⁽⁶⁷⁾		X					X	X				27.27
Lao et al.,⁽²⁷⁾		X				X					X	27.27
Carrier et al.,⁽¹⁵⁾		X				X					X	27.27
Molinari et al.,⁽³⁵⁾						X		X				18.18
Mean (%)	30.7	84.6	87.7	16.9	7.7	53.8	83	84.6	86.1	40	64.6	58.2

Quality tool	Categories
Quality tool	Very poor (%)	Poor (%)	Fair (%)	Good (%)	Excellent (%)
AMSTAR	6.2	24.6	46.2	21.5	1.5
PRISMA	0	10.8	35.4	47.7	6.2

Disease population	n	PRISMA >70% n (%)	AMSTAR >70% n (%)	PRISMA and AMSTAR >70% n (%)
CDH	6	1 (16.7)	2 (33.3)	1 (16.7)
Myelopathy	27	14 (51.8)	6 (22.2)	2 (7.4)
Spondylosis	9	9 (100)	2 (22.2)	2 (22.2)
DDD	22	11 (50)	5 (22.7)	5 (22.7)
ASD	1	0	0	0
p value		p=0.006	p=0.692	p=0.689

Instituto Israelita de Ensino e Pesquisa Albert Einstein Avenida Albert Einstein, 627/701 , 05651-901 São Paulo - SP, Tel.: (55 11) 2151 0904 - São Paulo - SP - Brazil
E-mail: revista@einstein.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Nelson Astur Avenida Albert Einstein, 627/701 – Morumbi Zip code: 05652-900 – São Paulo, SP, Brazil Phone: (55 11) 2151-9393 E-mail: nelsonan@yahoo.com