Meta-analysis of microdiscectomy versus standard discectomy in the treatment of Lumbar Disc Herniation

English Keywords:Lumbar disc herniation  Microdiscectomy  Standard discectomy  Meta-analysis

English Abstract:

  【Abstract】 Objective：To assess the effectiveness of microdiscectomy versus standard discectomy for lumbar disc herniation.Method：A computer-based online search of Medline（1977　to May，2010），EMBASE（1977　to May，2010），Cochrane Controlled Clinical Trials Register（1th Quarter 2010），Current Controlled Trials（２００３　to May，2010）.The China Biological Medicine Database（1984　to May，2010），and several　hand searched related journals　ｗｅｒｅ　ｐｅｒｆｏｒｍｅｄ.Ｔｈｅ　randomized　ａｎｄ controlled trials of microdiscectomy versus standard discectomy　ｗｅｒｅ　ｃｏｌｌｅｃｔｅｄ.The included trials were screened out ｓｔｒｉｃｔｌｙ　ｂａｓｅｄ　ｏｎ the criterion of inclusion and exclusion.The quality of included trials was evaluated.Data were extracted by two reviewers independently.RevMan 5.0 was used for data analysis.Result：Nine studies involving 1109 patients were included.There were 654 patients with microdiscectomy and 455 standard discectomies.The results of Meta-analysis indicated that statistically significant difference were observed between two approaches with respect to the mean operation time（P＜0.0５），blｏｏd　ｌｏｓｓ（P＜0.0１），ａｎｄ　postoperative VAS ｓｃｏｒｅ　of back pain（P<0.01）.Ｎｏ　difference ｗｉｔｈ　ｒｅｇａｒｄ　ｔｏ　the inpatient stay，complication，reoperation rate，postoperative VAS of leg pain and JOA score　ｗｅｒｅ　ｎｏｔｅｄ.Conclusion：Both microdiscectomy and standard discectomy are effective treatment for LDH.Ｃompareｄ with standard open discectomy，microdiscectomy ｉｓ　ｂｅｔｔｅｒ　due to　ｌｅｓｓ　ｂｌｏｏｄ　ｌｏｓｓ　ａｎｄ　better ｂａｃｋ　ｐａｉｎ　relief，but　ｌｏｎｇｅｒ operation time.There is no significant difference in overall effectiveness.