Abstract
Dear reader,
We appreciate your interest towards our article “Interventional Minimally Invasive Treatments for Chronic Low Back Pain Caused by Lumbar Facet Joint Syndrome: A Systematic Review”.
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We have carefully read your letter to the editor and acknowledged your constructive criticism towards our work. Please find enclosed our response below. 1. Although differently described in text, investigational treatments performed by Manchikanti2,3 and Civelek
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are detailed in Table 2. 2. Although the study from Manchikanti
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appropriately performed randomization, according to the Revised Cochrane risk-of-bias tool for randomized trials (RoB-2),
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we answered “No information” to item 1.2. (“Was the allocation sequence concealed until participants were enrolled and assigned to interventions?), resulting in the presence of “Some concerns” in the D1 domain. As per RoB-2 full guidance document, the reviewer should respond “Yes” “if the trial used any form of remote or centrally administered method to allocate interventions to participants, where the process of allocation is controlled by an external unit or organization, independent of the enrolment personnel” or “if envelopes or drug containers were used appropriately. Envelopes should be opaque, sequentially numbered, sealed with a tamper-proof seal and opened only after the envelope has been irreversibly assigned to the participant. Drug containers should be sequentially numbered and of identical appearance, and dispensed or administered only after they have been irreversibly assigned to the participant”. As the authors only mentioned that “randomization was carried out in blocks of 20 patients by a computer-generated random allocations sequence” and did not refer to the use of any envelopes,
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we could not conclude that abovementioned conditions were fulfilled. 3. Considering that both studies from Manchikanti et al2,3 did not report major intergroup differences, and that no formal meta-analysis could be conducted due to heterogeneity of included studies, we do not believe that aforementioned points would result in inappropriate evidence synthesis, therefore not substantially modifying the findings of our literature review.
