Meta-analysis Of Microendoscopic Discectomy Versus Open Lumbar Discectomy Treatment In Patients With Lumbar Disc Herniation

Objective:Efficacy and safety evaluation about microendoscopy discectomy and open lumbar discectomy in the treatment of lumbar disc herniation via meta-analysis.Methods:Researches on comparison between one-level microendoscopic discectomy and open discectomy in adults world-wide with prospective data collection from the Pubmed databases, the Cochrane Central Register of Controlled Trials,Embase databases,Medline databases,CNKI databases,CBM databases and Wanfang databases(1997-01/2014-09), and several hand searched related journals were performed.Two authors independently assessed trial quality and extracted data into an electrical sheet. Data of the treatment outcome,operation time, blood loss and length of hospital stay from these studies were abstracted and synthesized by a meta-analysis with Rev Man 5.1.Results:Seventeen studies involving 2551 cases were included. Results showed that: there were no significant differences in the treatment outcome(OR=1.22,95%CI:0.44~3.42,P=0.70)and the operation time(MD=2.22,95% CI:-2.37~6.80,P=0.34) between MED group and OLD group;there were significant difference between MED group and OLD group in terms of blood loss(MD=-81.24,95%CI:-111.00~-51.49,P<0.01)、size of incision(MD=-2.88,95%CI:-4.09~-1.68,P<0.01)、length of hospital stay(MD=-3.67,95%CI:-5.44~-1.90,P<0.01)、time to return to daily life(MD=-19.11,95% CI:-26.09~-12.13,P<0.01)and mean time in bed(MD=-9.09,95%CI:-13.28~-4.91,P<0.01).Conclusion:There were no significant differences in the treatment outcome and the operation time between microendoscopy discectomy and open lumbar discectomy; but microendoscopy discectomy was superior to open lumbar discectomy in intraoperative blood loss, size of incision, length of hospital stay, time to return to daily life and mean time in bed after operation.