A meta-analysis of percutaneous endoscopic discectomy and microdiscectomy for lumbar disc herniation: assessing surgical efficacy and clinical outcomes.

IF 1.5 4区医学 Q3 CLINICAL NEUROLOGY

Neurological Research Pub Date : 2025-10-01 Epub Date: 2025-05-31 DOI:10.1080/01616412.2025.2511086

Ahmed M Taha, Awad Hegab, Mohammed Yousef, Marwan Abdelhakam, Shaimaa Ahmed Dahshan

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引用次数: 0

Abstract

Background: Lumbar disc herniation is one of the commonest conditions affecting the lumbar spine, with disc fragments migrating in 35-72% of patients. It can be treated with either microdiscectomy or percutaneous endoscopic lumbar discectomy (PELD) surgeries.

Materials and methods: We searched these databases; Web of Science, PubMed, Cochrane Library, and SCOPUS. Overall, 26 studies, both randomized controlled trials and observational studies, were included. We analyzed different efficacy, safety, and functional outcomes including operation time, estimated blood loss (EBL), length of hospital stay, return to work period, pain scores, functional outcomes (Oswestry Disability Index (ODI) index, MacNab classification), and rates of complications, recurrence, and reoperation.

Results: Our results revealed that PELD was superior to MD in different studied outcomes including operation times (mean difference (MD) = -7.97 minutes, p = 0.004), I2 = 69%, return to work (MD = -3.21 weeks, p = 0.001), I2 = 52%, complication rates (OR = 0.70, p = 0.02), I2 = 23%, back pain (OR = -0.30, p = 0.001), and ODI scores (MD = -1.64%, p = 0.002). Both cohorts showed similar outcomes for leg pain (p = 0.31) and recurrence rates (p = 0.87). The rates of reoperation were higher in the PELD cohort compared to MD (OR = 1.47, p = 0.04).

Conclusion: PELD had better results than the MD group in most of our efficacy, safety, and clinical outcomes including ODI score, surgical time, blood loss, overall complications, and hospital stay while being comparable in the rest of the parameters assessed.

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经皮内窥镜椎间盘切除术和显微椎间盘切除术治疗腰椎间盘突出症的荟萃分析：评估手术疗效和临床结果。

背景：腰椎间盘突出是影响腰椎最常见的疾病之一，35-72%的患者有椎间盘碎片移位。它可以通过显微椎间盘切除术或经皮内窥镜腰椎间盘切除术（PELD）手术治疗。材料和方法：检索这些数据库；Web of Science, PubMed, Cochrane Library， SCOPUS。总共纳入了26项研究，包括随机对照试验和观察性研究。我们分析了不同的疗效、安全性和功能结局，包括手术时间、估计失血量（EBL）、住院时间、重返工作时间、疼痛评分、功能结局（Oswestry残疾指数（ODI）指数、MacNab分类）、并发症、复发率和再手术率。结果：我们的研究结果显示，PELD在不同的研究结果中优于MD，包括手术时间（平均差值(MD) = -7.97分钟，p = 0.004）， I2 = 69%，恢复工作（MD = -3.21周，p = 0.001）， I2 = 52%，并发症发生率（OR = 0.70, p = 0.02）， I2 = 23%，背部疼痛（OR = -0.30, p = 0.001）和ODI评分（MD = -1.64%, p = 0.002）。两个队列在腿部疼痛（p = 0.31）和复发率（p = 0.87）方面的结果相似。与MD组相比，PELD组的再手术率更高（OR = 1.47, p = 0.04）。结论：PELD在大多数疗效、安全性和临床结果（包括ODI评分、手术时间、出血量、总并发症和住院时间）方面优于MD组，而在其他评估参数方面具有可比性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurological Research 医学-临床神经学

CiteScore

3.60

自引率

0.00%

发文量

116

审稿时长

5.3 months

期刊介绍： Neurological Research is an international, peer-reviewed journal for reporting both basic and clinical research in the fields of neurosurgery, neurology, neuroengineering and neurosciences. It provides a medium for those who recognize the wider implications of their work and who wish to be informed of the relevant experience of others in related and more distant fields. The scope of the journal includes: •Stem cell applications •Molecular neuroscience •Neuropharmacology •Neuroradiology •Neurochemistry •Biomathematical models •Endovascular neurosurgery •Innovation in neurosurgery.