Comparison of the clinical efficacy of percutaneous transforaminal endoscopic discectomy and traditional laminectomy in the treatment of recurrent lumbar disc herniation

Applied Bionics and Biomechanics

Yao

Huang

et al. 2022

Objective. Spinal surgery is gradually moving toward minimally invasive surgery, but there is still some lack of knowledge about the Unilateral Biportal Endoscopic (UBE) technique that has been hotly debated in recent years. We performed this systematic review and meta-analysis to clarify whether UBE is superior to percutaneous endoscopic lumbar discectomy (PELD) for relieving short-term postoperative pain and promoting functional recovery. Methods. Computer searches of PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases were performed to search for studies on UBE versus PELD for single-segment lumbar disc herniation (ssLDH) from the time of database construction to Mar. 2022, and two investigators independently performed literature screening and data extraction, and evaluation of the quality of the included studies was observed as operation time, complications, and visual analogue scale (VAS) at each preoperative and postoperative stage as well as Oswestry Disability Index (ODI), and meta-analysis was performed by applying the Review Manager 5.4 software. Results. Meta-analysis showed that PELD had shorter operation time ( MD = 35.36 , 95% CI (4.67, 66.04), P = 0.02 ) and had lower VAS of back pain at 3 days postoperatively ( MD = 0.62 , 95% CI (0.04, 1.19), P = 0.04 ) compared to the UBE. However, there was no statistical significance between the two groups in terms of complications ( MD = 2.53 , 95% CI (0.40, 16.11), P = 0.33 ), VAS of back pain at 30 days postoperatively ( MD = 0.05 , 95% CI (-0.19, 0.28), P = 0.70 ), VAS of leg pain at 3 days postoperatively ( MD = 0.21 , 95% CI (-0.20, 0.61), P = 0.33 ), VAS of leg pain at 30 days postoperatively ( MD = 0.09 , 95% CI (-0.29, 0.46), P = 0.65 ), and ODI at 30 days postoperatively ( MD = − 0.81 , 95% CI (-3.03, 1.41), P = 0.47 ). Conclusions. Current evidence suggests that both UBE and PELD are effective in relieving short-term postoperative pain and promoting functional recovery, and there is no difference in complications between them; UBE requires longer operation time, and PELD may be superior in relieving immediate postoperative pain. This trial is registered with PROSPERO ID: CRD42021287810.

Section: Introductionmentioning

confidence: 99%

Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Applied Bionics and Biomechanics

Yao

Huang

et al. 2022

“…Therefore, patients undergoing TESSYS due to lumbar disc herniation should be guided to maintain good living habits, control their body weight, and avoid excessive pressure on the spine in order to maintain the treatment effect of the surgery. At present, recurrent intervertebral disc herniation is still treated mainly by traditional open surgery and minimally invasive interventional treatment [27][28][29]. Although traditional open surgery is more thorough in removing the herniation and ensuring the stability of the spine after fusion surgery, it will also lead to an increase in the surgical risk, operative time, intraoperative blood loss, and medical cost [30].…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of transforaminal endoscopic discectomy in the treatment of recurrent lumbar disc herniation: a single-center retrospective analysis

Xú

Zhang

BMC Musculoskelet Disord

et al. 2023

Purpose To investigate the clinical efficacy of transforaminal endoscopic discectomy (TED) in treating recurrent lumbar disc herniation. Methods Clinical datal of 31 patients who were hospitalized in the Department of Pain Management, First Affiliated Hospital of Nanchang University, between 2015 and 2018 due to recurrent lumbar disc herniation were collected and analyzed retrospectively. Visual analogue scale (VAS) scores and Japanese Orthopedic Association (JOA) scores were used to assess alterations of patients’ leg pain intensity and nerve function, respectively. The Modified MacNab criteria were used to evaluate patients’ excellent and good rates. Results Compared to clinical data before surgery, there was a significant reduction in VAS scores (P < 0.01) along with a significant improvement in JOA scores (P < 0.01) at 2 years after revision surgery. The patients’ excellent and good rates were 83.9% at the 2 years after surgery. Conclusion The TED is safe and effective in the long term and is applicable to the treatment of recurrent lumbar disc herniation.

“…At present, recurrent intervertebral disc herniation is still treated mainly by traditional open surgery and minimally invasive interventional treatment [19][20][21]. Although traditional open surgery is more thorough in removing the herniation and ensuring the stability of the spine after fusion surgery, it will also lead to an increase in the surgical risk, operative time, intraoperative blood loss, and medical cost [22].…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of transforaminal endoscopic discectomy in the treatment of recurrent lumbar disc herniation: A single-center retrospective analysis

Xú

Zhang

et al. 2022

Preprint

Purpose To investigate the clinical efficacy of transforaminal endoscopic discectomy in treating recurrent lumbar disc herniation. Methods Clinical datal of 31 patients who were hospitalized in the Department of Pain Management, First Affiliated Hospital of Nanchang University, between 2015 and 2018 due to recurrent lumbar disc herniation were collected and analyzed retrospectively. Visual analogue scale (VAS) scores and Japanese Orthopedic Association (JOA) scores were used to assess alterations of patients’ pain intensity and nerve function, respectively. The Modified MacNab criteria were used to evaluate patients’ excellent and good rates. Results Compared to clinical data before surgery, there was a significant reduction in VAS scores (P < 0.01) along with a significant improvement in JOA scores (P < 0.01) at 2 years after revision surgery. The patients’ excellent and good rates were 83.87% at the 2 years after surgery. Conclusion The transforaminal endoscopic discectomy is safe and effective in the long term and is applicable to the treatment of recurrent lumbar disc herniation.