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  • Clinical decision-making for spinal manipulation for persistent spinal pain following lumbar surgery: a protocol for a systematic review and meta-analysis of individual participant data

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Complementary medicine
Protocol
Clinical decision-making for spinal manipulation for persistent spinal pain following lumbar surgery: a protocol for a systematic review and meta-analysis of individual participant data
  1. Robert James Trager1,
  2. Clinton J Daniels2,
  3. Kevin W Meyer3,
  4. Amber C Stout4,
  5. Jeffery A Dusek1
  1. 1Connor Whole Health, University Hospitals of Cleveland, Cleveland, Ohio, USA
  2. 2RCS, VA Puget Sound Health Care System, Seattle, Washington, USA
  3. 3Rehabilitation Care Services, VA Puget Sound Health Care System American Lake Campus, Tacoma, Washington, USA
  4. 4Lakeside Hospital Library, University Hospitals of Cleveland, Cleveland, Ohio, USA
  1. Correspondence to Dr Robert James Trager; Robert.Trager{at}UHhospitals.org

Abstract

Introduction There are limited available research and guidance regarding the use of spinal manipulative therapy (SMT) in patients with low back-related symptoms following lumbar spine surgery, a condition called persistent spinal pain syndrome type 2 (PSPS-2). This publication outlines a review protocol to identify and synthesise individual participant data (IPD) to examine associations between patient, clinical and surgical variables and SMT application in adults with PSPS-2.

Methods and analysis PubMed, OVID, Web of Science, Scopus, PEDro, Index to Chiropractic Literature and KoreaMed will be searched from inception to 1 January 2022 without language restrictions. Case reports, series, observational studies and cases from grey literature of adults receiving SMT for PSPS-2 will be included. Two investigators will independently screen citations, abstracts and full-text articles. A risk-of-bias assessment will be performed in duplicate to rate cases according to exposure and outcome ascertainment and data completeness. Data extraction will be performed in duplicate and missing IPD will be requested from corresponding authors. Multiple binary logistic regression will be used to identify independent predictors of the use of lumbar–SMT, lumbar–manual-thrust SMT and SMT within 1-year postsurgery. Patient, clinical and surgical variables will be summarised using descriptive statistics, while SMT-related outcomes (lumbar–SMT, lumbar–manual-thrust SMT and 1-year surgery-to-SMT interval) will be described using adjusted ORs with 95% CIs.

Ethics and dissemination This study was deemed not human subjects research by the University Hospitals’ institutional review board. The results of this review will be disseminated at conferences and/or published in a peer-reviewed journal.

PROSPERO registration number CRD42021250039.

  • spine
  • rehabilitation medicine
  • back pain
  • complementary medicine
  • surgery
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2021-054070

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    Footnotes

    • Contributors RJT, CJD and JAD conceived, designed and coordinated the review protocol. ACS was responsible for designing the search strategy and screening methodology, RJT and KWM planned the data extraction methodology, and all authors contributed to writing the review protocol. RJT is the guarantor of this review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests RJT reports he has received book royalties from authoring two texts on the topic of sciatica.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.