Microsurgical discectomy versus microendoscopic discectomy for treatment of lumbar disc herniations: a meta-analysis

doi:10.3969/j.issn.2095-4344.2014.31.020

Abstract

Abstract:

BACKGROUND: Microsurgical discectomy and microendoscopic discectomy are effective safe methods for treatment of lumbar disc herniations. Currently, the comparative study on two kinds of microtechnology was less, and the conclusion of each study is different.
OBJECTIVE: To compare the safety and effectiveness between microsurgical discectomy and microendoscopic discectomy for treatment of lumbar disc herniations using meta-analysis.
METHODS: Cochrane Library, PubMed, CNKI, VIP, Web of Science and Wanfang were searched for articles published from building to November 2013. Related journals were retrieved by hand. Randomized controlled trials of microsurgical discectomy and microendoscopic discectomy for treatment of lumbar disc herniations were collected. Qualities of included studies were evaluated using RevMan 5.2 software, and then analyzed by meta-analysis.
RESULTS AND CONCLUSION: A total of 5 randomized controlled trials involving 1 430 cases were included. The results of meta-analysis indicated that no significant difference between microsurgical discectomy and microendoscopic discectomy groups was detected in the length of hospital stay [MD=-0.19 (-0.43, 0.05), P=0.13], the improvement rate of Oswestry disability index [MD=2.78 (-0.15, 5.72), P=0.06], the improvement rate of
visual analogue scale [MD=1.96 (-0.29, 4.21), P=0.09] and the root injure [RR= 0.20 (0.03, 1.12), P=0.07]. Compared with microendoscopic discectomy, microsurgical discectomy showed less surgical time [MD=-10.13 (-14.06, -6.21), P < 0.000 01], less blood loss [MD=-24.27 (-39.45, -9.08), P=0.002], lower incidence of dural tear [RR=0.28(0.11, 0.68), P=0.005], lower risk of recurrent herniation [RR=0.34 (0.14, 0.83), P=0.02]. Above data showed that microsurgical discectomy for lumbar disc herniations was safe and effective under the same condition, but with updated technology and equipment, above conclusion is not necessarily always the same. We suggested that clinical physicians should choose a manner based on practical condition. This topic still requires the verification of more high-quality randomized controlled trials, and the conclusion should be updated promptly.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: intervertebral disk displacement, microsurgery, diskectomy, randomized controlled trial, meta-analysis

CLC Number:

R318

Liu Meng-jun, Du Bin, Wei Xin-wei, Wang Shi-hai, Lin Qing, Wang Song, Chen Zhi-xin. Microsurgical discectomy versus microendoscopic discectomy for treatment of lumbar disc herniations: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(31): 5036-5043.

Figures/Tables 4

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