Percutaneous endoscopic lumbar discectomy for recurrent lumbar disc herniation: a Meta-analysis

English Keywords:Recurrent lumbar disc herniation  Percutaneous endoscopy  Discectomy  Complications  Meta-analysis

English Abstract:

  【Abstract】 Objectives: To evaluate the safety and complication rate of percutaneous endoscopic discectomy for recurrent lumbar disc herniation through Meta-analysis. Methods: PubMed, EMbase, The Cochrane Library, CBM, WanFang Data and CNKI databases were searched by computer to collect clinical studies on complications related to percutaneous endoscopic lumbar discectomy for recurrent lumbar disc herniation. The retrieval time was from the establishment of the database to August 2019. The Meta-analysis was performed by Revman 5.3 software after two researchers independently selected literature, extracted data and evaluated the bias risk of the study. Results: A total of 1252 patients were enrolled in 13 clinical studies, including 1 randomized controlled trial and 12 cohort studies. Meta-analysis showed that the overall complications[OR=0.46, 95%CI(0.25, 0.87), P=0.02] and dural tear rate[OR=0.16, 95%CI(0.05, 0.56), P=0.004] of PELD were lower than those of traditional fenestration nucleus pulposus removal(P<0.05), but compared with MED and MIS-TLIF, there were no significant differences in the overall complications, dural tear, nerve root injury and incomplete nucleus pulposus removal rate(P>0.05). Conclusions: PELD has a lower incidence of complications and a higher safety than traditional fenestration nucleus pulposus remova in the treatment of recurrent lumbar disc herniation. PELD is a safe and effective method to treat recurrent lumbar disc herniation without imaging instability.