Department of Orthopedics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, People's Republic of China.
Department of Orthopedics, First Affiliated Hospital of Gannan Medical University General Hospital, No. 23 Qingnian Road, Zhanggong District, Ganzhou, 341000, People's Republic of China.
J Orthop Surg Res. 2018 Jul 5;13(1):169. doi: 10.1186/s13018-018-0868-0.
The open microdiscectomy is the most common surgical procedure for the decompression of radiculopathy caused by lumbar disk herniation. To date, a variety of minimally invasive (MI) techniques have been developed. In the last decades, endoscopic techniques have been developed to perform discectomy. The transforaminal endoscopic discectomy (TED) with posterolateral access evolved out of the development of endoscopic techniques.
A systematic literature search was performed using the PubMed, EMBASE, and Cochrane Library databases for trials written in English. The randomized trials and observational studies that met our inclusion criteria were subsequently included. Two reviewers respectively extracted data and estimated the risk of bias. All statistical analyses were performed using Review Manager 5.3.
Five prospective and four retrospective studies involving 1527 patients were included. The results of the meta-analysis indicated that there were significant differences between the two groups in length of hospital stay (MD = - 8.41, 95% CI - 10.26, - 6.56; p value < 0.00001). However, there were no significant differences in the leg visual analog scale (VAS) scores, the Oswestry Disability Index (ODI) scores, and the incidence of complications and recurrence.
The transforaminal endoscopic discectomy is superior to open microdiscectomy in the length of hospital stay. However, there were no differences in leg pain, functional recovery, and incidence of complications between TED and MD in treating LDH.
开放式微椎间盘切除术是治疗腰椎间盘突出症引起的神经根病最常见的手术方法。迄今为止，已经开发出了各种微创 (MI) 技术。在过去的几十年中，已经开发出了内镜技术来进行椎间盘切除术。经椎间孔内窥镜椎间盘切除术 (TED) 经后外侧入路是内镜技术发展的结果。
使用 PubMed、EMBASE 和 Cochrane 图书馆数据库对用英文撰写的试验进行了系统的文献检索。随后纳入符合我们纳入标准的随机试验和观察性研究。两位审阅者分别提取数据并评估偏倚风险。所有统计分析均使用 Review Manager 5.3 进行。
纳入了 5 项前瞻性研究和 4 项回顾性研究，共涉及 1527 名患者。荟萃分析的结果表明，两组在住院时间（MD = - 8.41，95%CI - 10.26，- 6.56；p 值 < 0.00001）方面存在显著差异。然而，两组在腿部视觉模拟量表 (VAS) 评分、Oswestry 残疾指数 (ODI) 评分以及并发症和复发发生率方面均无显著差异。
经椎间孔内窥镜椎间盘切除术在住院时间方面优于开放式微椎间盘切除术。然而，在治疗腰椎间盘突出症时，TED 与 MD 在腿部疼痛、功能恢复和并发症发生率方面并无差异。
