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KMID : 1155620220170020001
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Journal of Korea CHUNA Manual Medicine for Spine & Nerves
2022 Volume.17 No. 2 p.1 ~ p.16
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Manual Therapy for Failed Back Surgery Syndrome: A Systematic Review
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Yoon Hong-Ryoul
Jeong Ji-Hong
Kim Soon-Joong
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Abstract
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Objectives : This study aimed to assess the efficacy and safety of manual therapy in patients with failed back surgery syndrome (FBSS).
Methods : We searched eight electronic databases from October 2022 and only selected randomized controlled trials (RCTs) reporting outcomes for manual therapy in FBSS patients. Included studies were analyzed qualitatively.
Results : A total of twelve RCTs were included and three studies were meta-analyzed.
Manual therapy combined with exercise demonstrated more favorable outcomes in terms of pain reduction compared to exercise therapy only (P<0.01). Some studies reported that manual therapy resulted in low efficacy, while some studies reported that specific manual techniques have a significant effect in pain relief. We, therefore, conclude that several studies have a high risk of bias.
Conclusions : Findings suggest that manual therapy is a safe and non-invasive, promising option for managing FBSS. However, manual therapy is not the best option in all circumstances; thus, this should be selectively applied by a well-trained practitioner.
Further studies such as well-designed, risk-controlled RCTs are required to gain stronger evidence.
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KEYWORD
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Failed back surgery syndrome, Manual therapy, Chuna manual therapy, Systematic review, Meta-analysis
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