A meta-analysis of the efficacies of visualized foraminoplasty vs traditional foraminoplasty under spinal endoscopy in the treatment of lumbar degenerative disease

English Keywords:Lumbar degenerative disease  Percutaneous endoscopic lumbar discectomy  Visualized foraminoplasty  Meta-analysis

English Abstract:

  【Abstract】 Objectives: To systematically compare the clinical efficacies of visualized endoscopic foraminoplasty and traditional foraminoplasty in the treatment of degenerative lumbar diseases. Methods: Literature of clinical comparative studies of visualized foraminoplasty(visualized group) and traditional foraminoplasty(traditional group) in the treatment of lumbar degenerative diseases were searched from the databases such as CNKI, VIP, WANFANG DATA, and PubMed from the inception to December 2023. The Newcastle-Ottawa scale(NOS) was used to evaluate the quality of the included retrospective case-control studies, and the Cochrane Risk of Bias Tool was used to assess the risk of bias in the included prospective randomized controlled studies. The main efficacy indicators of the two groups[operative time, C-arm fluoroscopy frequency, hospitalization time, complications, visual analogue scale(VAS) score, and Oswestry disability index(ODI)] were statistically analyzed. RevMan 5.3 software was used for Meta-analysis of the literature that met the inclusion criteria. Results: A total of 4 prospective studies and 12 retrospective studies were included. The NOS evaluation indicated that the retrospective studies were of medium to high quality, and the Cochrane risk of bias assessment showed a low risk of bias in the prospective studies. A total of 1, 239 patients were included, with 642 in the visualized group and 597 in the traditional group. Meta-analysis results showed that the the visualized group had fewer C-arm X-ray fluoroscopies(MD=-8.16, 95%CI: -10.06--6.27, P<0.001) and shorter operative time(MD=-17.18, 95%CI: -21.48--12.88, P<0.001) compared to the traditional group. There were no statistically significant differences between the two groups in terms of hospitalization time, VAS score, ODI improvement, or postoperative complications(P>0.05). Conclusions: Both visualized endoscopic foraminoplasty and traditional endoscopic foraminoplasty can achieve good clinical efficacies in the treatment of degenerative lumbar diseases. However, visualized endoscopic foraminoplasty has shorter operative time and fewer C-arm fluoroscopies compared to traditional endoscopic foraminoplasty.