Barricaid annular closure device for reduction of symptomatic reherniation and reoperation after lumbar discectomy: systematic review and Meta-analysis

English Keywords:Barricaid annular closure device  Lumbar disc herniation  Reherniation  Reoperation

English Abstract:

  【Abstract】 Objectives: To explore the effect of annular closure device(ACD) on the symptomatic reherniation and reoperation rate after lumbar discectomy(LD) by Meta-analysis. Methods: Databases including MEDLINE, EMBASE, PubMed, and Cochrane Central Register were searched for literature on the prevention of symptomatic reherniation and reduction of reoperation rate of disc herniation after lumbar discectomy by using Barricaid ACD. Two researchers independently screened the literature and evaluated the risk of bias in the included studies. After that, relevant data about the symptomatic reherniation and reoperation rate of lumbar disc herniation within 2 years after operation were extracted using ACD(ACD group) or not(control group). A Meta-analysis by Revman 5.3 software was adopted to analyze the symptomatic reherniation and reoperation rates in ACD group and control group within 3 months, 1 year, 2 years, 3 years and 4 years after operation, retrospectively. Results: A total of 14 literatures were included, of which 6 were analyzed for the recurrence of protrusion within 2 years after operation. And a total of 873 cases of patients were after lumbar discectomy, including 407 cases in ACD group and 466 cases in control group. The results of Meta-analysis showed that: the symptomatic reherniation of protrusion within 2 years after operation in ACD group was significantly reduced (OR: 0.35; OR: 0.05; OR: 0.05); 95%CI: 0.22, 0.55; I2=0%; P<0.00001), and that the reoperation rate within 2 years after operation in ACD group was significantly lower than that in control group (OR: 0.46; P<0.05); 95%CI: 0.29, 0.74; I2=0%; P=0.001). Ten studies collected 550 patients after lumbar discectomy, including 272 patients in ACD group and 278 patients in control group. The reoperation rate within 3 months, 1 year, 2 years, 3 years and 4 years after operation and the symptomatic reherniation rate within 3 months, 1 year, 2 years and 3 years after operation in ACD group were lower than those in the control group. Conclusions: Compared with lumbar discectomy, lumbar discectomy with the Barricaid annulus closure device significantly reduced the symptomatic reherniation rate and reoperation in patients.