A Meta Analysis of Percutaneous Transforaminal Endoscopic Discectomy Versus Microendoscopic Discectomy for Treatment of Lumbar Disc Herniation
XIANG Jiao
ZHAO Jia-gui
CHEN Jia-hua
Abstract：Objective To systematically compare and evaluate the safety and effectiveness between percutaneous transforaminal endoscopic lumbar discectomy and microendoscopic discectomy in treatment of lumbar disc herniation. Methods Cochrane Library, PubMed, Medline, Ovid, SpringerLink, the China Biological Medicine Database, CNKI, VIP and Wan-fang Database were searched for articles published from the building of data base up to September 2014. Related journals were retrieved by hand. Randomized controlled trials of percutaneous transforaminal endoscopic lumbar discectomy and microendos-copy discectomy in treatment of lumbar disc herniation were collected. The eligible trials were extracted according to the inclu-sion and exclusion criteria. The Cochrane Collaboration's RevMan 5. 2 software was used for data analysis. Results A total of 4 RCTs involving 650 patients were included, 327 PTED cases and 323 MED cases were enrolled. The results of meta-analysis showed that when compared with microendoscopic discectomy, percutaneous endoscopic lumbar discectomy entailed less intra-operative blood loss(MD= -39. 49, 95%CI-64. 65 ~ -14. 32, Z=3. 08, P=0. 002), smaller incision size (MD =-10. 25, 95%CI-13. 02~ -7. 48, Z=7. 25, P<0. 00001), shorter bed time after operation(MD= -55. 42, 95%CI-66. 05~ -44. 80, Z=10. 22, P<0. 00001) and shorter hospitalization stay ( MD= -3. 95, 95%CI -5. 27~ -2. 63, Z=5. 87, P <0. 00001), but there were no significant differences in the mean operation time (MD =17. 30, 95%CI-4. 03~38. 64, Z=1. 59, P=0. 11), the visual analogue scale after operation(MD= -0. 03, 95%CI-0. 26~0. 21, Z=0. 22, P=0. 83), the improvement rate of Oswestry disability index (MD=2. 38, 95%CI -0. 93~5. 70, Z=1. 41, P=0. 16) and the rate of complications (OR=1. 36, 95%CI 0. 46~4. 04, Z =0. 55, P=0. 58). Conclusion The meta-anal-ysis shows that PTED and MED are equally effective and safe, but PTED has been found to be less invasive. Since the quality and quantity of the research included is limited, more high-quality randomized controlled trials with long-term follow-up are needed for further assessment of these outcomes.
Keywords：Intervertebral disc displacementLumbar vertebraePercutaneous transforaminal endoscopyMicroen-doscopyDiskectomyRandomized controlled trialMeta analysis
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 83-89 )