Table 1

Risk of bias assessment for studies on non-operative treatment for lumbar spinal stenosis with neurogenic claudication

AuthorABCDEFGHIJKLTotal
Calcitonin
Eskola et al??+++?+–???+5
Porter and Hibbert??–??++?–?++4
Porter and Miller??+??–++???+4
Podichetty et al??+++–+–+??+6
Tafazal et al??++++++–??+7
Sahin et al??––+–?++??+4
Oral medications
      Prostaglandin
Matsudaria++––+++?+??+7*
Methylcabalin
Waikakul and Waikakul–?––+++?+??+5
      Gabapentin
Yaksi et al??–––?++???+3
      Pregabalin
Markman et al++++++++?+–+10‡
      Gabapentin
Park et al+?++++++??–+8‡
      Oxymorphone hydrochloride
Markman et al+++++–?+?+++9†§
      Oral corticoid
Rodrigues and Natour++???++????+5
Rehabilitation therapy or multimodal care
Goren et al++––++–++??+7*
Koc et al??––+++–+??+5
Pua et al++––+–+++?–+7*
Whitman et al+?––+++++??+7
Minetama et al+?––++++?+++8‡
Schneider et al++––+–+++?++8*
Ammendolia et al++––++++++++10*
Oğuz et al??––??+–???+2
Homayouni et al++––+++––+?+7†
Marchand et al++––+?++?–++7†
Kim et al++++++++?+++11*
Spinal manipulation
Passmore et al–+––+++–++++8†
Acupuncture
Kim et al++––––++–+++7†
Qin et al+++–+++++–++10*
Epidural injections
Cuckler et al??+++++++?++9
Fukusaki et al????+++++?++7
Zahaar??+?+++++–?–6
Brown+–+–?++–??–+5
Friedly et al, Friedly et al and Makris++++++++?+++11*
Song et al?????++–?+++5
Milburn et al??+–+–+–?––+4
Hammerich et al++––+–+??–++6†
Sencan et al+?+–++?+++?+8‡
Wei et al+++––+–+?+++8*
Percutaneous epidural adhesiolysis
Karm et al+?+–+–++?––+6‡
Surgery versus physical therapy
Zucherman et al, Zucherman et al and Hsu et al?+––++++?++>6¶
Weinstein et al, Weinstein et al, Abdu et al++––++++??–+>6 *** ††
Amundsen et al+?–––+++–?–?4
Malmivaara et al++––+++++??+8*
Weinstein et al, Weinstein et al, Lurie et al++––+–++??–+6††
Delitto et al++––+?+–+–++7††

KEY:
A: Was the method of randomisation adequate?
B: Was the treatment allocation concealed?
C: Was the patient blinded to the intervention?
D: Was the care provider blinded to the intervention?
E: Was the outcome assessor blinded to the intervention?
F: Was the drop-out rate described and acceptable?
G: Were all randomised participants analysed in the group to which they were allocated?
H: Are reports of the study free of suggestion of selective outcome reporting?
I: Were the groups similar at baseline regarding the most important prognostic indicators?
J: Were cointerventions avoided or similar?
K: Was the compliance acceptable in all groups?
L: Was the timing of the outcome assessment similar in all groups? +: Yes, –: No, ?: Unclear.

*Low risk of bias if six or more items met, including valid randomisation and treatment allocation techniques and no severe flaws.

†<30 participants per treatment arm.

‡Treatment allocation unclear.

§Premature end of study.

¶2-year follow-up drop-out rate 30%, 1 year<20%; intention to treat inconsistent at 2-year follow-up. **Drop-out rate<20% at 1 year, >20% at 4 years. ††Severe flaw due to high cross-over rates.