Comparison of percutaneous endoscopic lumbar discectomy versus open lumbar microdiscectomy for lumbar disc herniation: A meta-analysis.
OBJECTIVE
The purpose of the study is to perform a systematic review and meta-analysis to evaluate the clinical results of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for the treatment of lumbar disc herniation (LDH).


METHODS
Randomized controlled trials or non-randomized controlled trials published from the time when databases were built to March 2016 that compared the clinical effectiveness of PELD and OLM surgical approaches for the treatment of LDH were acquired by a comprehensive search in four electronic databases (PubMed, EMBASE, Web of Science and Cochrane library). A total of 7 studies (1389 patients) were included in this systematic review and meta-analysis. Pooled mean differences (MD) and odds ratios (OR) and with 95% CIs were calculated for the outcomes.


RESULTS
The results showed that there were no statistically between the PELD group and OLM group in terms of preoperative VAS-BP score (WMD = 0.03; 95% CI: -0.99 to 1.05; P = 0.95), postoperative VAS-BP score (WMD = -0.56; 95% CI: -1.43 to 0.31; P = 0.21), postoperative ODI (WMD = -0.98; 95% CI: -4.96 to 3.00; P = 0.63), complication rate (OR = 1.79; 95% CI: 0.95 to 3.37; P = 0.07) or reoperation rate (OR = 1.44; 95% CI: 0.94 to 2.20; P = 0.09). PELD group was associated with shorter operation time (WMD = -12.83; 95% CI: -24.79 to -0.87; P = 0.04) and hospital stay (WMD = -5.49; 95% CI: -8.63 to -2.35; P = 0.0006).


CONCLUSIONS
The existing evidence indicate that no superiority exists between the two surgical approaches for the treatment of LDH in terms of functional outcome, complication rate and reoperation rate, in spite of that PELD surgical group can achieve shorter operation time and hospital stay than OLM surgical group.
Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China.
Wenfeng
W
Ruan
Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China.
Fan
F
Feng
Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China.
Zhengye
Z
Liu
Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China.
Jiangtao
J
Xie
Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China.
Lin
L
Cai
Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China. Electronic address: Pingyifeng319@aliyun.com.
Ansong
A
Ping
D017586:Diskectomy / Q000379:methods*; D017587:Diskectomy, Percutaneous / Q000379:methods; D004724:Endoscopy; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D016896:Treatment Outcome
Lumbar disc herniation; Microdiscectomy; Percutaneous endoscopic lumbar discectomy; Posterior approach; Surgery; Treatment outcome