Is Saline Injection a True Sham/Placebo Treatment in Randomized Controlled Trials? A Systematic Review

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Good

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Very good

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Good

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Very good

Comments: The Discussion section assesses whether intradiscal injection of saline is a sham/placebo agent or it has potential therapeutic effects when used as control treatment in randomized controlled trials (RCTs) for the management of discogenic low back pain by reviewing selected articles of RCTs. It thoroughly analyses the comprehensive literature to gain a better understanding of the role of saline in the treatment of discogenic low back pain. Lastly, it concludes that the use of intradiscal saline appears to have some analgesic benefits like local anaesthetics and steroids when used individually.

Literature

Q: Does the author utilize relevant literature?

A: Very good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Very good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Good

Comments: The legend of Figure 1 has not been provided.

Writing style

Q: Is it clear and understandable?

A: Good

Comments:

·       The word “Systematic” is misspelled in the title of the article.

·       In the 4^th sentence of the 3^rd paragraph of the Introduction, “to” should be replaced with “for” after “explanation”.

·       The last sentence of the 8^th paragraph of the Results does not make sense. Hence, it should be rephrased as “The authors conclude that there was no statistical significance and there was no advantage in using chymopapain.”

·       The 1^st sentence of the 7^th paragraph of the Discussion is incomplete. Hence, it has been merged with the next sentence and reframed as “Although the mechanism of pain and disability improvement with intradiscal saline injection is yet unclear, there is… IVD acidic media [5].”

·       In the 2^nd sentence of the 9^th paragraph of the Discussion, “show similar” should be replaced with “showed similarities” after “VAS and ODI”.

·       In the 3^rd sentence of the 9^th paragraph of the Discussion, “Although” should be replaced with “However” in the beginning.

·       In the 2^nd sentence of the Conclusion, “for” should be replaced with “to” after “detrimental”.

·       In the legend of Table 1, “summarizes” should be replaced with “Summary of” in the beginning of the sentence.

·       Words like “whether”, “data”, “their” are misspelled in the text section of the article.

·       Articles and punctuations are missing in several places throughout the text.

Further comments on the paper

Comments: This systematic review represents a comprehensive literature review of 95 articles, describing the administration of intradiscal saline solution used as a placebo for chronic pain management. It further investigates the effects of saline as a placebo in the treatment of discogenic low back pain when administered into the intervertebral disc in randomized controlled trials (RCTs). This is the first systematic review in literature that elucidates whether the saline solution is a really inactive agent, or it might have some therapeutic effects when used to evaluate interventional treatment of discogenic pain. The purpose of this study is to review the world literature of the published RCTs to treat discogenic pain involving the use of intradiscal injection of saline as a sham treatment arm.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Thanks,
Science Repository Team