척추 수술 실패 증후군에 대한 수기요법의 효과: 체계적 문헌 고찰

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.