Methodological Quality of the Studies
Studies focusing on initial diagnostic imaging were mostly of low to
moderate quality or had serious to critical risk of bias (Table 2). One
study on preoperative blood tests in ASA grade I patients respected 9/10
cases series quality criteria22, while another met
half of these criteria.38 Among studies on initial
consultation and therapeutic interventions (Table 3), those on spine
consultation after a thoracolumbar transverse process fracture had
serious risk of bias. Among studies evaluating immobilization, RCTs had
serious risk of bias or some concerns were identified, while systematic
reviews were of low to critically low quality. Similarly, for
post-treatment imaging and follow-up consultations (Table 4), systematic
reviews were of critically low quality, RCTs had high risk of bias,
retrospective studies had moderate to critical risk of bias and only 17
of 32 case series (n=17/32) met at least 70% of methodological quality
criteria (Table 4).