Open AccessTubular microscopes discectomy versus conventional microdiscectomy for treating lumbar disk herniation
Author(s) -
Xianbo Li,
Hengrui Chang,
Xianzhong Meng
Publication year - 2018
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000009807
Subject(s) - medicine , visual analogue scale , oswestry disability index , randomized controlled trial , meta analysis , discectomy , surgery , lumbar , lumbar disc herniation , low back pain , alternative medicine , pathology
Background: The application of tubular microscopes discectomy (TMD) was supposed to have similar or better results than conventional microdiscectomy (CMD). However, this conclusion had not been verified by sufficient evidence. Therefore, the focus of this meta-analysis was to assess the efficiency, safety, and clinical outcome of these 2 surgical procedures for treating lumbar disk herniation (LDH). Methods: PubMed, Embase, and Cochrane Collaboration Central databases were searched for studies which compared the results of TMD and CMD for the treatment of LDH up to July 2017. Data analysis was conducted using RevMan 5.3. A standardized electronic form of 17 predefined criteria from the Consort statement was used for the quality assessment. Results: Eight randomized controlled trials (RCT) and 2 retrospective studies were included in this review, including 804 patients. The pooled analysis showed that there was no significant difference in operative time ( P = .38), blood loss ( P = .14), the length of hospital stay ( P = .47), the rate of intraoperative complications ( P = .79), postoperative complications ( P = .16), dural tear ( P = .87), the reoperation ( P = .20), the short-term back visual analog scale (VAS) scores ( P = .76), the long-term back VAS scores ( P = .64), the short-term leg VAS scores ( P = .09), the long-term leg VAS scores ( P = .35), and the Oswestry disability index (ODI) scores ( P = .41). Conclusion: The results of this meta-analysis demonstrate that TMD and CMD are both safe and effective surgical procedures which can be recommended for treating LDH. Additionally, the conclusion should be cautiously treated, because it was reached in the context of limited amount of studies and relatively small sample size. Therefore, future studies with good design and more large samples are required to validate this conclusion.