Hebei North University, Zhangjiakou, Hebei, China.
Spinal Surgery Medical Team of Orthopedics, Hebei General Hospital, Shijiazhuang, Hebei, China.
Medicine (Baltimore). 2022 Sep 30;101(39):e30412. doi: 10.1097/MD.0000000000030612.
The purpose of this study was to analyze unilateral biportal endoscopic discectomy (UBE) and percutaneous endoscopic lumbar discectomy (PELD) for the treatment of lumbar disc herniation.
PubMed, EMBASE, Web of Science, Cochrane Database, CNKI, and Wanfang databases were searched online. All statistical analyses were performed using STATA 16.0.
The selection criteria were met by 6 studies with a total of 281 patients (142 cases in the UBE group and 139 cases in the PELD group) and good methodological quality. PELD has the potential to improve outcomes such as operation time and intraoperative hemorrhage (MD = 36.808, 95% CI (23.766, 49.850), P = .000; MD = 59.269, 95% CI (21.527, 97.010), P = .000) compared with UBE. No differences were found in the back pain VAS score at preoperative (MD = -0.024, 95% CI [-0.572, 0.092], P = .998), at 1 day after operation (MD = -0.300, 95% CI [-0.845, 0.246], P = .878), the VAS score of leg pain at preoperative (MD = -0.099, 95% CI [-0.417, 0.220], P = .762), at 1 day after operation (MD = 0.843, 95% CI [0.193, 1.492], P = .420), at 1 month after operation (MD = -0.027, 95% CI [-0.433, 0.380], P = .386), at 6 months after operation (MD = 0.122, 95% CI [-0.035, 0.278], P = .946), hospital stay (MD = 3.708, 95% CI [3.202, 4.214], P = .000) and other clinical effects between UBE and PELD group.
There are no significant differences in clinical efficacy between UBE and PELD, according to the research. However, PELD has the potential to improve outcomes such as operation time and intraoperative hemorrhage. As just a result, PELD is better suited in the treatment of lumbar disc herniation.
本研究旨在分析单边双通道内镜下椎间盘切除术(UBE)和经皮内镜腰椎间盘切除术(PELD)治疗腰椎间盘突出症的效果。
通过在线搜索 PubMed、EMBASE、Web of Science、Cochrane 数据库、中国知网(CNKI)和万方数据库,纳入了所有符合标准的研究,并使用 STATA 16.0 进行了所有统计学分析。
符合纳入标准的研究共有 6 项,共纳入 281 例患者(UBE 组 142 例,PELD 组 139 例),且方法学质量较高。与 UBE 相比,PELD 可能改善手术时间和术中出血量等结局(MD=36.808,95%CI(23.766,49.850),P=0.000;MD=59.269,95%CI(21.527,97.010),P=0.000)。两组术前(MD=-0.024,95%CI[-0.572,0.092],P=0.998)、术后 1 天(MD=-0.300,95%CI[-0.845,0.246],P=0.878)腰痛视觉模拟评分(VAS)、术前(MD=-0.099,95%CI[-0.417,0.220],P=0.762)、术后 1 天(MD=0.843,95%CI[0.193,1.492],P=0.420)腿痛 VAS、术后 1 个月(MD=-0.027,95%CI[-0.433,0.380],P=0.386)、术后 6 个月(MD=0.122,95%CI[-0.035,0.278],P=0.946)VAS、住院时间(MD=3.708,95%CI[3.202,4.214],P=0.000)等临床疗效差异均无统计学意义。
根据本研究,UBE 和 PELD 治疗腰椎间盘突出症的临床疗效差异无统计学意义。然而,PELD 可能在改善手术时间和术中出血量等方面具有优势。因此,PELD 更适合治疗腰椎间盘突出症。