Yang Jiameng, Liu Rui, Miao Yu, Nian Liwei, Meng Xiaotao
Department of Orthopedics, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China.
Department of Orthopedics, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China.
World Neurosurg. 2023 Apr;172:88-93. doi: 10.1016/j.wneu.2023.02.009. Epub 2023 Feb 9.
Postoperative recurrence of percutaneous endoscopic lumbar disc increases the physical damage and financial burden on patients and negatively affects physicians' treatment decisions. We conducted this meta-analysis to explore the risk factors for postoperative recurrence of percutaneous endoscopic lumbar disc for lumbar disc herniation.
We conducted article search in the PubMed, EMBASE and Cochrane Library databases. PRISMA guidelines were followed in this review. The data are statistically analyzed by the Roundup Manager (version 3.6.1). The results of the meta-analysis are presented in the form of forest-like plots.
We included 13 articles and identified 7524 cases. Patients with older age (odds ratio [OR] = 1.28, 95% confidence interval [CI]: 1.18-1.40), higher body mass index (OR = 1.16, 95% CI: 1.05-1.28), smoker (OR = 1.73, 95% CI: 0.95-3.15), degenerative grades ≥3 (OR = 6.07, 95% CI: 2.81-13.11), and postoperative sagittal motion ≥10° (OR = 2.42, 95% CI: 1.63-3.58) have a higher recurrence rate.
A thorough preoperative evaluation is essential to prevent postoperative recurrence of percutaneous endoscopic lumbar discectomy. The study addresses several factors of preoperative evaluation, which is hopeful to provide a reference for neurosurgeons.
经皮内镜下腰椎间盘手术的术后复发增加了患者的身体损伤和经济负担，并对医生的治疗决策产生负面影响。我们进行了这项荟萃分析，以探讨腰椎间盘突出症经皮内镜下腰椎间盘手术术后复发的危险因素。
我们在PubMed、EMBASE和Cochrane图书馆数据库中进行文献检索。本综述遵循PRISMA指南。数据由RevManager（版本3.6.1）进行统计分析。荟萃分析结果以森林图的形式呈现。
我们纳入了13篇文章，共7524例病例。年龄较大（比值比[OR]=1.28，95%置信区间[CI]：1.18-1.40）、体重指数较高（OR=1.16，95%CI：1.05-1.28）、吸烟者（OR=1.73，95%CI：0.95-3.15）、退变分级≥3（OR=6.07，95%CI：2.81-13.11）以及术后矢状面活动度≥10°（OR=2.42，95%CI：1.63-3.58）的患者复发率较高。
全面的术前评估对于预防经皮内镜下腰椎间盘切除术的术后复发至关重要。本研究探讨了术前评估的几个因素，有望为神经外科医生提供参考。
