Rompiendo el efecto ‘‘techo de cristal’’ en la generación de evidencia clínica de alto nivel en ortopedia y traumatología

Autores/as

  • Kai-Uwe Lewandrowski Center for Advanced Spine Care of Southern Arizona. Tucson, USA
  • Jorge Felipe Ramírez León Reina Sofía Clinic. Bogotá D.C., Colombia
  • Álvaro Dowling Endoscopic Spine Clinic. Santiago, Chile
  • Manuel Rodríguez García Spine Clinic. México City, México
  • José Gabriel Rugeles Cecimin. Bogotá, Colombia.
  • Carolina Ramírez Cecimin. Bogotá, Colombia
  • Alfonso García Hospital Angeles Tijuana. Tijuana, México.
  • Jose Valerio Miami Neuroscience Center at Larkin. Miami, USA
  • Paulo Sérgio Teixeira de Carvalho Gaffre e Guinle University Hospital. Rio de Janeiro, Brazil.
  • Luis Miguel Duchén Rodríguez Center for Neurological Diseases. La Paz, Bolivia
  • Jaime Moyano
  • Mario Herrera Fundación Universitaria Sanitas. Bogotá, D.C., Colombia
  • Nicolás Prada Universidad Autónoma de Bucaramanga. Bucaramanga, Colombia
  • Mauricio Zuluaga Clínica Imbanaco. Cali, Colombia
  • Anthony Yeung Desert Institute for Spine Care. Phoenix, USA

DOI:

https://doi.org/10.1016/j.rccot.2022.10.003

Palabras clave:

ensayo controlado aleatorizado, protocolo de ensayo clínico, diseño de investigaciones epidemiológicas, estudios de cohortes, estadísticas

Resumen

Introducción: En los estudios clínicos relacionados con problemas ortopédicos comunes y lesiones traumáticas, los métodos de aleatorización son difíciles de orquestar. La falta de evidencia clínica de alto nivel que tomen como fuente estudios prospectivos, aleatorizados y doble ciego, se cita a menudo como una razón principal para rechazar los avances terapéuticos propuestos en cirugía ortopédica.
Materiales y métodos: Este documento de opinión resume las limitaciones de los ensayos clínicos en las subespecialidades quirúrgicas. Se presente un consenso acerca de cómo el cirujano ortopédico en ejercicio puede producir evidencia clínica de alta calidad y de esta forma realizar cambios en sus protocolos de práctica clínica.
Resultados: Esta revisión de la literatura reveló que las clasificaciones del nivel de evidencia varían entre las subespecialidades quirúrgicas. La investigación en la ortopedia y traumatología se dirige principalmente al diagnóstico, el tratamiento preferido y el análisis de decisiones económicas, mientras que otras clasificaciones de pronóstico son preferidas en otras áreas, como cirugía plástica. En ortopedia, los estudios doble ciego controlados son raros y, a menudo, pocos prácticos o, incluso, pocos éticos. El cruzamiento entre ensayos quirúrgicos aleatorios de grupos de estudio es más común. Otras dificultades en los ensayos quirúrgicos van desde: la falta de apoyo organizativo y financiero, aprobación institucional o comité de ética y requisitos de registro para los ensayos clínicos, y hasta tiempo insuficiente por fuera de un programa clínico, ya ocupado para dedicarle a esta laboriosa tarea no compensada.
Conclusión: La cirugía ortopédica es una subespecialidad basada en la experiencia y la habilidad. Muchas innovaciones comienzan con cirujanos emprendedores reportando informes de opiniones o estudios de cohortes retrospectivos, muchos de los cuales tienen sesgo. Los estudios de cohortes observacionales prospectivos con resultados consistentes pueden ofrecer evidencia clínica de mayor grado que los ensayos aleatorios mal ejecutados.

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

Kai-Uwe Lewandrowski, Center for Advanced Spine Care of Southern Arizona. Tucson, USA

Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson AZ, USA, Full Professor Departmemt of Orthopaedics, Fundación Universitaria Sanitas, Bogotá, D.C., Colombia.

Jorge Felipe Ramírez León, Reina Sofía Clinic. Bogotá D.C., Colombia

Minimally Invasive Spine Center, Bogotá, D.C., Colombia, Reina Sofía Clinic, Bogotá, D.C., Colombia, Department of Orthopaedics, Fundación Universitaria Sanitas, Bogotá, D.C., Colombia.

Álvaro Dowling, Endoscopic Spine Clinic. Santiago, Chile

Orthopaedic Spine Surgeon, Director of Endoscopic Spine Clinic, Santiago, Chile.

Manuel Rodríguez García, Spine Clinic. México City, México

Spine Clinic, The American-Bitish Cowdray Medical Center I.A.P, Campus Santa Fe, México City, México.

José Gabriel Rugeles, Cecimin. Bogotá, Colombia.

Cecimin, Bogotá, Colombia.

Carolina Ramírez, Cecimin. Bogotá, Colombia

Cecimin, Bogotá, Colombia.

Alfonso García, Hospital Angeles Tijuana. Tijuana, México.

Espalda Saludable, Hospital Angeles Tijuana, Tijuana, B. C. México.

Jose Valerio, Miami Neuroscience Center at Larkin. Miami, USA

Neurosurgery Chair Palmetto steward General Hospital Co-Director Miami Neuroscience Center at Larkin, FL USA.

Paulo Sérgio Teixeira de Carvalho, Gaffre e Guinle University Hospital. Rio de Janeiro, Brazil.

Pain and Spine Minimally Invasive Surgery Service at Gaffre e Guinle University Hospital, Rio de Janeiro, Brazil.

Luis Miguel Duchén Rodríguez, Center for Neurological Diseases. La Paz, Bolivia

President of the Chapter of the Vertebral Column of the Latin American Federation of Neurosurgery Societies, Bolivian Spine Association, Public University of El Alto and Center for Neurological Diseases, La Paz, Bolivia.

Jaime Moyano

Ortopedia y Traumatología, Ecuador.

Mario Herrera, Fundación Universitaria Sanitas. Bogotá, D.C., Colombia

Clínica Colombia. Fundación Universitaria Sanitas, Bogotá, D.C., Colombia.

Nicolás Prada, Universidad Autónoma de Bucaramanga. Bucaramanga, Colombia

Profesor Cirugía de Columna, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia.

Mauricio Zuluaga, Clínica Imbanaco. Cali, Colombia

Ortopedista y traumatólogo, Clínica Imbanaco. Cali, Colombia.

Anthony Yeung, Desert Institute for Spine Care. Phoenix, USA

Desert Institute for Spine Care, Phoenix, AZ, USA, Executive Director, International Intradisccal Therapy Society (IITS.org).

Referencias bibliográficas

Safiri S, Kolahi AA, Smith E, et al. Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017. Ann Rheum Dis. 2020;79:819-28. https://doi.org/10.1136/annrheumdis-2019-216515

Coury HJ. Time trends in ergonomic intervention research for improved musculoskeletal health and comfort in Latin America. Appl Ergon. 2005;36:249-52. https://doi.org/10.1016/j.apergo.2004.10.010

Rockhold FW. Industry perspectives on ICH guidelines. Stat Med. 2002;21:2949-57. https://doi.org/10.1002/sim.1299

Malik AY, Foster C. The revised Declaration of Helsinki: cosmetic or real change? J R Soc Med. 2016;109:184-9. https://doi.org/10.1177/0141076816643332

Shrestha BM. The Declaration of Helsinki in relation to medical research: historical and current perspectives. J Nepal Health Res Counc. 2012;10:254-7.

Riis P. Thirty years of bioethics: the Helsinki Declaration 1964-2003. New Rev Bioeth. 2003;1:15-25. https://doi.org/10.1080/1740028032000131396

Declaration of Helsinki. Recommendations guiding doctors in clinical research. Adopted by the World Medical Association in 1964. Wis Med J 1967;66:25-6.

Murano G. International Conference on Harmonization-critical discussion of the biotech'Specifications' document. Curr Opin Biotechnol. 2000;11:303-8. https://doi.org/10.1016/S0958-1669(00)00100-2

The periodic health examination. Canadian Task Force on the Periodic Health Examination. Can Med Assoc J 1979;121:1193-254.

Sackett DL. Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest. 1989;95:2s-4s. https://doi.org/10.1378/chest.95.2_Supplement.2S

Burns PB, Rohrich RJ, Chung KC. The levels of evidence and their role in evidence-based medicine. Plast Reconstr Surg. 2011;128:305-10. https://doi.org/10.1097/PRS.0b013e318219c171

Ariyan S, Martin J, Lal A, et al. Antibiotic prophylaxis for preventing surgical-site infection in plastic surgery: an evidence-based consensus conference statement from the American Association of Plastic Surgeons. Plast Reconstr Surg. 2015;135:1723-39. https://doi.org/10.1097/PRS.0000000000001265

Sullivan D, Chung KC, Eaves FF3rd, et al. The Level of Evidence Pyramid: Indicating Levels of Evidence in Plastic and Reconstructive Surgery Articles. Plast Reconstr Surg. 2021;148:68s-71s. https://doi.org/10.1097/01.prs.0000794868.07051.b4

Perdikis G, Dillingham C, Boukovalas S, et al. American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline Revision: Reduction Mammaplasty. Plast Reconstr Surg. 2022;149:392e-409e. https://doi.org/10.1097/PRS.0000000000008860

Centre for Evidence Based Medicine (CEBM). 2013.

Solheim O. Randomized controlled trials in surgery and the glass ceiling effect. Acta Neurochir (Wien). 2019;161:623-5. https://doi.org/10.1007/s00701-019-03850-3

Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. Jama. 2006;296:2441-50. https://doi.org/10.1001/jama.296.20.2441

Abdu WA, Sacks OA, Tosteson ANA, et al. Long-Term Results of Surgery Compared With Nonoperative Treatment for Lumbar Degenerative Spondylolisthesis in the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). 2018;43:1619-30. https://doi.org/10.1097/BRS.0000000000002682

From the American Society of Plastic Surgeons. Evidence-based clinical practice guidelines.

Watters W, 3rd, Rethman MP, Hanson NB, et al. Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures. J Am Acad Orthop Surg. 2013;21:180-9. https://doi.org/10.5435/JAAOS-21-03-180

Meiyappan KP, Cote MP, Bozic KJ, et al. Adherence to the American Academy of Orthopaedic Surgeons Clinical Practice Guidelines for Nonoperative Management of Knee Osteoarthritis. J Arthroplasty. 2020;35:347-52. https://doi.org/10.1016/j.arth.2019.08.051

Bono CM, Watters WC3rd, Heggeness MH, et al. An evidencebased clinical guideline for the use of antithrombotic therapies in spine surgery. Spine J. 2009;9:1046-51. https://doi.org/10.1016/j.spinee.2009.09.005

Bono CM, Ghiselli G, Gilbert TJ, et al. An evidence-based clinical guideline for the diagnosis and treatment of cervical radiculopathy from degenerative disorders. Spine J. 2011;11:64-72. https://doi.org/10.1016/j.spinee.2010.10.023

Kreiner DS, Shaffer WO, Baisden JL, et al. An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (update). Spine J. 2013;13:734-43. https://doi.org/10.1016/j.spinee.2012.11.059

Shaffer WO, Baisden JL, Fernand R, et al. An evidence-based clinical guideline for antibiotic prophylaxis in spine surgery. Spine J. 2013;13:1387-92. https://doi.org/10.1016/j.spinee.2013.06.030

Kaiser MG, Eck JC, Groff MW, et al. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 1: introduction and methodology. J Neurosurg Spine. 2014;21:2-6. https://doi.org/10.3171/2014.4.SPINE14257

Kreiner DS, Hwang SW, Easa JE, et al. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J. 2014;14:180-91. https://doi.org/10.1016/j.spinee.2013.08.003

Kreiner DS, Baisden J, Mazanec DJ, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of adult isthmic spondylolisthesis. Spine J. 2016;16:1478-85. https://doi.org/10.1016/j.spinee.2016.08.034

Matz PG, Meagher RJ, Lamer T, et al. Guideline summary review: An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Spine J. 2016;16:439-48. https://doi.org/10.1016/j.spinee.2015.11.055

Tan SY, Linskey K. Christiaan Barnard (1922-2001): First heart transplant surgeon. Singapore Med J. 2019;60:495-6. https://doi.org/10.11622/smedj.2019127

Gawande A. Two Hundred Years of Surgery. New England Journal of Medicine. 2012;366:1716-23. https://doi.org/10.1056/NEJMra1202392

Moseley JB, O'Malley K, Petersen NJ, et al. A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee. New England Journal of Medicine. 2002;347:81-8. https://doi.org/10.1056/NEJMoa013259

Sihvonen R, Paavola M, Malmivaara A, et al. Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear. New England Journal of Medicine. 2013;369:2515-24. https://doi.org/10.1056/NEJMoa1305189

Buchbinder R, Osborne RH, Ebeling PR, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009;361:557-68. https://doi.org/10.1056/NEJMoa0900429

Paavola M, Malmivaara A, Taimela S, et al. Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: randomised, placebo surgery controlled clinical trial. BMJ. 2018;362:k2860. https://doi.org/10.1136/bmj.k2860

Probst P, Grummich K, Harnoss JC, et al. Placebo-Controlled Trials in Surgery: A Systematic Review and Meta-Analysis. Medicine. 2016;95:e3516. https://doi.org/10.1097/MD.0000000000003516

Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical versus nonsurgical therapy for lumbar spinal stenosis. N Engl J Med. 2008;358:794-810. https://doi.org/10.1056/NEJMoa0707136

Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). 2008;33:2789-800. https://doi.org/10.1097/BRS.0b013e31818ed8f4

Pearson AM, Blood EA, Frymoyer JW, et al. SPORT lumbar intervertebral disk herniation and back pain: does treatment, location, or morphology matter? Spine (Phila Pa 1976). 2008;33:428-35. https://doi.org/10.1097/BRS.0b013e31816469de

Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007;356:2257-70. https://doi.org/10.1056/NEJMoa070302

Martin E, Muskens IS, Senders JT, et al. Randomized controlled trials comparing surgery to non-operative management in neurosurgery: a systematic review. Acta Neurochirurgica. 2019;161:627-34. https://doi.org/10.1007/s00701-019-03849-w

Hempel S, Miles SMJNV, et al. Empirical Evidence of Associations Between Trial Quality and Effect Size [Internet]. Agency for Healthcare Research and Quality (US); 2011 Jun. [Table]. Jadad Scale.]. 2022. Available at: https://www.ncbi.nlm.nih.gov/books/NBK56923/table/appendixes.app6.t1/.

Augestad KM, Berntsen G, Lassen K, et al. Standards for reporting randomized controlled trials in medical informatics: a systematic review of CONSORT adherence in RCTs on clinical decision support. J Am Med Inform Assoc. 2012;19:13-21. https://doi.org/10.1136/amiajnl-2011-000411

Moher D, Schulz KF, Altman D. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. Jama. 2001;285:1987-91. https://doi.org/10.1001/jama.285.15.1987

Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet. 2001;357:1191-4. https://doi.org/10.1016/S0140-6736(00)04337-3

Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. Ann Intern Med. 2001;134:657-62. https://doi.org/10.7326/0003-4819-134-8-200104170-00011

Lewandrowski KU, de Carvalho PST, Calderaro AL, et al. Outcomes with transforaminal endoscopic versus percutaneous laser decompression for contained lumbar herniated disc: a survival analysis of treatment benefit. J Spine Surg. 2020;6. S99-S84. https://doi.org/10.21037/jss.2019.09.13

Lewandrowski KU, Dowling A, de Carvalho P, et al. Indication And Contraindication Of Endoscopic Transforaminal Lumbar Decompression. World Neurosurg. 2020. https://doi.org/10.1016/j.wneu.2020.03.076

Lewandrowski KU, Yeung A. Meaningful outcome research to validate endoscopic treatment of common lumbar pain generators with durability analysis. J Spine Surg. 2020;6:S6-13. https://doi.org/10.21037/jss.2019.09.07

Lewandrowski KU, Tieber F, Hellinger S, et al. Durability of Endoscopes Used During Routine Lumbar Endoscopy: An Analysis of Use Patterns, Common Failure Modes. Impact on Patient Care, and Contingency Plans. Int J Spine Surg. 2021;15:1147-60. https://doi.org/10.14444/8146

Schulz KF, Chalmers I, Hayes RJ, et al. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. Jama. 1995;273:408-12. https://doi.org/10.1001/jama.1995.03520290060030

Reed CC, Wolf WA, Cotton CC, et al. A visual analogue scale and a Likert scale are simple and responsive tools for assessing dysphagia in eosinophilic oesophagitis. Aliment Pharmacol Ther. 2017;45:1443-8. https://doi.org/10.1111/apt.14061

Fairbank J. Use of Oswestry Disability Index (ODI). Spine (Phila Pa 1976). 1995;20:1535-7. https://doi.org/10.1097/00007632-199507000-00020

Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000;25:2940-52, discussion 52. https://doi.org/10.1097/00007632-200011150-00017

Macnab I. The surgery of lumbar disc degeneration. Surg Annu. 1976;8:447-80.

Lewandrowski KUPSTDECPDEC, et al. Minimal Clinically Important Difference in Patient-Reported Outcome Measures with the Transforaminal Endoscopic Decompression for Lateral Recess and Foraminal Stenosis. Int J Spine Surg. 2020;14:254-66. https://doi.org/10.14444/7034

Denis F, Basch E, Septans AL, et al. Two-Year Survival Comparing Web-Based Symptom Monitoring vs Routine Surveillance Following Treatment for Lung Cancer. Jama. 2019;321:306-7. https://doi.org/10.1001/jama.2018.18085

Barcot O, Boric M, Dosenovic S, et al. Adequacy of risk of bias assessment in surgical vs non-surgical trials in Cochrane reviews: a methodological study. BMC Medical Research Methodology. 2020;20:240. https://doi.org/10.1186/s12874-020-01123-7

Gurusamy KS, Gluud C, Nikolova D, et al. Assessment of risk of bias in randomized clinical trials in surgery. British Journal of Surgery. 2009;96:342-9. https://doi.org/10.1002/bjs.6558

Nerland US, Jakola AS, Solheim O, et al. Minimally invasive decompression versus open laminectomy for central stenosis of the lumbar spine: pragmatic comparative effectiveness study. Bmj. 2015;350:h1603. https://doi.org/10.1136/bmj.h1603

Jakola AS, Skjulsvik AJ, Myrmel KS, et al. Surgical resection versus watchful waiting in low-grade gliomas. Ann Oncol. 2017;28:1942-8. https://doi.org/10.1093/annonc/mdx230

von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. The Lancet. 2007;370:1453-7. https://doi.org/10.1016/S0140-6736(07)61602-X

Kaplan E, Meier P. Nonparametric estimation from incomplete observations. Journal of the American Statistical Association. 1958;53:457-81. https://doi.org/10.1080/01621459.1958.10501452

Altman D, Machin D, Bryant T, et al. Statistics with confidence: confidence intervals and statistical guidelinesed:. John Wiley & Sons; 2013.

Yeung A, Lewandrowski KU. Five-year clinical outcomes with endoscopic transforaminal foraminoplasty for symptomatic degenerative conditions of the lumbar spine: a comparative study of inside-out versus outside-in techniques. J Spine Surg. 2020;6:S66-83. https://doi.org/10.21037/jss.2019.06.08

Yeung A, Lewandrowski KU. Early and staged endoscopic management of common pain generators in the spine. J Spine Surg. 2020;6:S1-5. https://doi.org/10.21037/jss.2019.09.03

Lewandrowski K-U, Abraham I, Ramírez León JF, et al. A Proposed Personalized Spine Care Protocol (SpineScreen) to Treat Visualized Pain Generators: An Illustrative Study Comparing Clinical Outcomes and Postoperative Reoperations between Targeted Endoscopic Lumbar Decompression Surgery, Minimally Invasive TLIF and Open Laminectomy. Journal of Personalized Medicine. 2022;12:1065. https://doi.org/10.3390/jpm12071065

Ramirez Leon JF, Ardila AS, Rugeles Ortiz JG, et al. Standalone lordotic endoscopic wedge lumbar interbody fusion (LEW-LIF) with a threaded cylindrical peek cage: report of two cases. J Spine Surg. 2020;6. S275-S84. https://doi.org/10.21037/jss.2019.06.09

Ramirez Leon JF. The motivators to endoscopic spine surgery implementation in Latin America. J Spine Surg. 2020;6:S45-8. https://doi.org/10.21037/jss.2019.09.12

Ramirez LF, Thisted R. Complications and demographic characteristics of patients undergoing lumbar discectomy in community hospitals. Neurosurgery. 1989;25, 226-230 discussion 30-1. https://doi.org/10.1097/00006123-198908000-00012

Ruetten S, Komp M, Merk H, et al. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine (Phila Pa 1976). 2008;33:931-9. https://doi.org/10.1097/BRS.0b013e31816c8af7

Osterman H, Seitsalo S, Karppinen J, et al. Effectiveness of microdiscectomy for lumbar disc herniation: a randomized controlled trial with 2 years of follow-up. Spine (Phila Pa 1976). 2006;31:2409-14. https://doi.org/10.1097/01.brs.0000239178.08796.52

Knight MT, Goswami A, Patko JT, et al. Endoscopic foraminoplasty: a prospective study on 250 consecutive patients with independent evaluation. J Clin Laser Med Surg. 2001;19:73-81. https://doi.org/10.1089/104454701750285395

Sampath P, Bendebba M, Davis JD, et al. Outcome in patients with cervical radiculopathy Prospective, multicenter study with independent clinical review. Spine (Phila Pa 1976). 1999;24:591-7. https://doi.org/10.1097/00007632-199903150-00021

Hermantin FU, Peters T, Quartararo L, et al. A prospective, randomized study comparing the results of open discectomy with those of video-assisted arthroscopic microdiscectomy. J Bone Joint Surg Am. 1999;81:958-65. https://doi.org/10.2106/00004623-199907000-00008

Choy DS. Percutaneous laser disc decompression (PLDD): twelve years' experience with 752 procedures in 518 patients. J Clin Laser Med Surg. 1998;16:325-31. https://doi.org/10.1089/clm.1998.16.325

Birkenmaier C, Komp M, Leu HF, et al. The current state of endoscopic disc surgery: review of controlled studies comparing full-endoscopic procedures for disc herniations to standard procedures. Pain Physician. 2013;16:335-44. https://doi.org/10.36076/ppj.2013/16/335

Ruetten S, Komp M, Merk H, et al. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine (Phila Pa 1976). 2008;33:940-8. https://doi.org/10.1097/BRS.0b013e31816c8b67

Ruetten S, Komp M, Merk H, et al. Recurrent lumbar disc herniation after conventional discectomy: a prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision. J Spinal Disord Tech. 2009;22:122-9. https://doi.org/10.1097/BSD.0b013e318175ddb4

Lee DY, Shim CS, Ahn Y, et al. Comparison of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for recurrent disc herniation. J Korean Neurosurg Soc. 2009;46:515-21. https://doi.org/10.3340/jkns.2009.46.6.515

Kong L, Shang XF, Zhang WZ, et al. Percutaneous endoscopic lumbar discectomy and microsurgical laminotomy: A prospective, randomized controlled trial of patients with lumbar disc herniation and lateral recess stenosis. Orthopade. 2019;48:157-64. https://doi.org/10.1007/s00132-018-3610-z

Rong L. Erratum. Percutaneous transforaminal endoscopic discectomy compared with microendoscopic discectomy for lumbar disc herniation: 1-year results of an ongoing randomized controlled trial. J Neurosurg Spine. 2019:1-3. https://doi.org/10.3171/2019.5.SPINE161434a

Chiarotto A, Maxwell LJ, Terwee CB, et al. Roland-Morris Disability Questionnaire and Oswestry Disability Index: Which Has Better Measurement Properties for Measuring Physical Functioning in Nonspecific Low Back Pain? Systematic Review and Meta-Analysis. Phys Ther. 2016;96:1620-37. https://doi.org/10.2522/ptj.20150420

Barber MD, Chen Z, Lukacz E, et al. Further validation of the short form versions of the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ). Neurourol Urodyn. 2011;30:541-6. https://doi.org/10.1002/nau.20934

Jenkinson C, Layte R. Development and testing of the UK SF-12 (short form health survey). J Health Serv Res Policy. 1997;2:14-8. https://doi.org/10.1177/135581969700200105

Descargas

Publicado

2022-10-25

Cómo citar

1.
Lewandrowski K-U, Ramírez León JF, Dowling Álvaro, Rodríguez García M, Rugeles JG, Ramírez C, et al. Rompiendo el efecto ‘‘techo de cristal’’ en la generación de evidencia clínica de alto nivel en ortopedia y traumatología. Rev. colomb. ortop traumatol. [Internet]. 25 de octubre de 2022 [citado 22 de julio de 2024];36(4):215-28. Disponible en: https://revistasccot.org/index.php/rccot/article/view/108

Número

Sección

Artículo original
QR Code