Meta-analysis of the operative treatment of lumbar disc herniation via transforaminal percutaneous endoscopic discectomy versus interlaminar percutaneous endoscopic discectomy in randomized trials.

Szczegóły
Abstrakt

Tytuł:: Meta-analysis of the operative treatment of lumbar disc herniation via transforaminal percutaneous endoscopic discectomy versus interlaminar percutaneous endoscopic discectomy in randomized trials.
Autorzy:: He DW; Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, China.
Xu YJ
Chen WC
Miao XX
Wu H
Wu TL
Jia JY
Cheng XG
Źródło:: Medicine [Medicine (Baltimore)] 2021 Feb 05; Vol. 100 (5), pp. e23193.
Typ publikacji:: Journal Article; Meta-Analysis
Język:: English
Imprint Name(s):: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
MeSH Terms:: Diskectomy, Percutaneous/*methods
Intervertebral Disc Displacement/*surgery
Lumbar Vertebrae/*surgery
Fluoroscopy/statistics & numerical data ; Humans ; Operative Time ; Postoperative Complications/epidemiology ; Randomized Controlled Trials as Topic ; Retrospective Studies
References:: Sekiguchi M, Kikuchi S, Myers RR. Experimental spinal stenosis: relationship between degree of cauda equina compression, neuropathology, and pain. Spine (Phila Pa 1976) 2004;29:1105–11.
Bruggeman AJ, Decker RC. Surgical treatment and outcomes of lumbar radiculopathy. Phys Med Rehabil Clin N Am 2011;22:161–77.
Kambin P, Sampson S. Posterolateral percutaneous suction-excision of herniated lumbar intervertebral discs. Report of interim results. Clin Orthop Relat Res 1986;207:37–43.
Ruetten S, Komp M, Merk H, et al. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine (Phila Pa 1976) 2008;33:931–9.
Schreiber A, Leu H. Percutaneous nucleotomy: technique with discoscopy. Orthopedics 1991;14:439–44.
Choi G, Lee SH, Raiturker PP, et al. Percutaneous endoscopic interlaminar discectomy for intracanalicular disc herniations at L5-S1 using a rigid working channel endoscope. Neurosurgery 2006;58: ((1 Suppl)): 59–68.
Yeung AT, Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976) 2002;27:722–31.
Suri P, Pearson AM, Zhao W, et al. Pain recurrence after discectomy for symptomatic lumbar disc herniation. Spine (Phila Pa 1976) 2017;42:755–63.
Kyung-Chul C, Jin-Sung K, Kyeong-Sik R, et al. Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation: transforaminal versus interlaminar approach. Pain Physician 2013;16:547–56.
Yongjin L, Bolai C, Yufeng W, et al. Transforaminal percutaneous endoscopic discectomy vs. interlaminar percutaneous endoscopic discectomy in the treatment of lumbar disc herniation. Guangdong Med J 2016;37:15535–21537.
Chao L, Lei C, Hao-Chuan Y, et al. Percutaneous endoscopic lumbar discectomy for highly migrated lumbar disc herniation. Pain Physician 2017;20:E75–84.
Hongfei N, Jiancheng Z, Yueming S, et al. Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation via an interlaminar approach versus a transforaminal approach. Spine (Phila Pa 1976) 2016;41: (Suppl 19): B30–7.
Sebastian R, Martin K, Harry Me, et al. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique. Spine (Phila Pa 1976) 2008;33:931–9.
Tong S. Percutaneous Endoscopic Lumbar Discectomy for L5-S1 Disc Herniation: Transforaminal versus Interlaminar Approach [Master Thesis]. Zhejiang, China: Zhejiang University; 2016.
Xi-liang T, Yang Q, Wang B, et al. Surgical approach analysis of percutaneous endoscopic lumbar discectomy. J Spinal Surg 2015;13:342–6.
Yuanbin X. Comparison of Transforaminal and Interlaminar Approach for Percutaneous Endoscopic Discectomy and Discuss the Indications [Master Thesis]. Dalian, China: Dalian Medical University; 2017.
Zhou X. Comparisons of Interlaminar and Transforaminal Approach for Percutaneous Endoscopic Lumbar Discectomy [Master Thesis]. Chongqing, China: Chongqing Medical University; 2013.
Fei Y. Analysis of the Clinical Curative Effect on Two Kinds of Endoscopic Approach for the Treatment of L4/5 Intervertebral Disc Herniation [Master Thesis], Chengdu, China: Chengdu University of Traditional Chinese Medicine; 2015.
Li Y, Zhijian D, Suoliang W, et al. The comparative effectiveness of two different approach in treatment of calcified lumbar disc herniation by percutaneous transforaminal endoscopic discectomy. Chin J Pain Med 2017;4:277–82.
Yuanyu Z, Wei J, Shuwei Z, et al. Clinical effects of percutaneous endoscopic L5/S1 lumbar discectomy through transforaminal approach and interlaminar approach. Orthopead Biomech Mater Clin Study 2017;14:64–8.
Peng Z, Jianze C, Xin Y, et al. Clinical effect of discectomy with percutaneous endoscopic through transforaminal and interlaminar approach for very high-grade migrated lumbar disc herniation. Chin J Clin 2017;5:1675–80.
Pan L, Zhang P, Yin Q. Comparison of tissue damages caused by endoscopic lumbar discectomy and traditional lumbar discectomy: a randomized controlled trial. Int J Surg 2014;12:534–7.
Entry Date(s):: Date Created: 20210217 Date Completed: 20210303 Latest Revision: 20230103
Update Code:: 20240104
PubMed Central ID:: PMC7870223
DOI:: 10.1097/MD.0000000000023193
PMID:: 33592819
: Czasopismo naukowe

Full Text Finder

Backgrounds: Transforaminal percutaneous endoscopic discectomy (TF-PELD) and interlaminar percutaneous endoscopic discectomy (IL-PELD) are the most common alternative treatments of lumbar disc herniation. The aim of this study was to compare the operation time duration and X-ray exposure as well as outcomes of TF-PELD and IL-PELD as indicated by the published clinical evidences within randomized trials.
Methods: We included randomized, controlled studies reporting operation duration and X-ray exposure as well as clinical outcome evaluations, comparing TF-PELD to IL-PELD with a minimum of 10 patients per group. The included data measures were operation duration, X-ray exposure and postoperation evaluations. Data were synthesized and analyzed using ReviewManager version 5.3. Publication bias was evaluated via funnel plot. The Cochran Q test and the degree of inconsistency (I2) were used to assess heterogeneity. Lowly biased and heterogenous dichotomous data were calculated by odds ratio and continuous data were calculated by mean difference (MD) with 95% confidence intervals (CI).
Results: Thirteen studies published from January 1970 to March 2018, with a total of 770 lumbar disc herniation patients, including 361 cases of TF-PELD and 409 cases of IL-PELD, were finally included. Meta-analysis of data extracted from these studies revealed that the postoperation outcomes of both surgery methods did not differ significantly, but the surgery duration was significantly shorter in the IL-PELD group than in the TF-PELD group (MD 21.69; 95% CI 12.94-30.27; P = .00001), and the fluoroscopy times demanded in the IL-PELD group was significantly fewer than those in the TF-PELD group (MD 7.57; 95% CI 6.22-8.93; P = .00001).
Conclusion: The main finding of the study is that IL-PELD approach can decrease radiation exposure as their demanded duration of operation and fluoroscopy times were significantly shorter and fewer in the IL-PELD group, which they achieve similar outcomes comparing to TF-PELD. The study is limited at a lack of samples with lumbar disc herniation levels out of L5/S1. The findings implicate selection of IL-PELD approach over TF-PELD at applicable circumstances for lower lumbar disc herniation. Physicians should consider this data when choosing between TF-PELD and IL-PELD.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Informacja