Mishra Sandeep, Regmi Sabina, Garg Kanwaljeet
Department of Neurosurgery, Lok Nayak Hospital, New Delhi, India.
Department of Neuroanaesthesia and Critical Care, Lok Nayak Hospital, New Delhi, India.
World Neurosurg. 2023 Sep;177:109-121. doi: 10.1016/j.wneu.2023.06.064. Epub 2023 Jun 22.
This meta-analysis evaluated the impact of lumbar disk herniation and lumbar spinal stenosis (LSS) on axial back pain and the extent of improvement of axial and radicular pain following lumbar decompression and discectomy surgery in patients with low back pain (LBP).
A systematic search for published literature between January 2012 and January 2023 was made on PubMed, Google Scholar, and Cochrane library database on 31 January 2023. Original articles that included patients with lumbar disc herniation or LSS who underwent lumbar discectomy or lumbar decompression respectively were included in the study.
A total of 71 studies including 16,770 patients with LBP undergoing lumbar discectomy or decompression surgery were included in the meta-analysis. The pooled standard mean difference between postoperative and preoperative: Visual Analog Scale scores for leg pain was -5.14 with 95% confidence interval (CI): -6.59 to -3.69 (P-value = 0) and for back pain was -2.90 with 95% CI: -3.79 to -2.01 (P value = 0), Numerical pain Rating Scale for leg pain was -1.64 with 95% CI: -1.97 to -1.30 (P-value<0.01) and for back pain was -1.58 with 95% CI: -1.84 to -1.32 (P-value <0.01), Oswerty Disability Index score was -4.76 with 95% CI: -6.22 to -3.29 (P-value = 0) and the Japanese Orthopaedic Association score was 3.45 with 95% CI: 0.02 to 6.88 (P value 0) at follow-up.
This meta-analysis provides evidence that lumbar discectomy and decompression are effective in improving axial LBP in patients with lumbar disk herniation and LSS.
本荟萃分析评估腰椎间盘突出症和腰椎管狭窄症（LSS）对下腰痛（LBP）患者轴向背痛的影响，以及腰椎减压和椎间盘切除术后轴向和根性疼痛的改善程度。
于2023年1月31日在PubMed、谷歌学术和Cochrane图书馆数据库中系统检索2012年1月至2023年1月发表的文献。纳入分别接受腰椎间盘切除术或腰椎减压术的腰椎间盘突出症或LSS患者的原始文章。
荟萃分析共纳入71项研究，包括16770例接受腰椎间盘切除术或减压手术的LBP患者。术后与术前的合并标准平均差：腿痛视觉模拟量表评分为-5.14，95%置信区间（CI）：-6.59至-3.69（P值=0），背痛为-2.90，95%CI：-3.79至-2.01（P值=0）；腿痛数字疼痛评分量表评分为-1.64，95%CI：-1.97至-1.30（P值<0.01），背痛为-1.58，95%CI：-1.84至-1.32（P值<0.01）；Oswerty功能障碍指数评分为-4.76，95%CI：-6.22至-3.29（P值=0），随访时日本矫形外科学会评分为3.45，95%CI：0.02至6.88（P值=0）。
本荟萃分析提供了证据，表明腰椎间盘切除术和减压术可有效改善腰椎间盘突出症和LSS患者的轴向LBP。
