A Meta-analysis Of The Efficacy Of Percutaneous Endoscopic Intervertebral Foraminal Approach And Interlaminar Approach In The Treatment Of Single-segment Lumbar Disc Herniation

Objectives: To evaluate the effect of percutaneous endoscopic intervertebral foraminal approach and interlaminar approach in the treatment of single-segment lumbar disc herniation systematically,and to provide certain guidance and basis for the selection of surgical approach in clinical practice.Methods: The inclusion and exclusion criteria of literature were formulated,appropriate effect indicators were selected,and Pub Med,Medline,Cochrane,cnki and wanfang databases were searched by computer.The Newcastle Ottawa scale(NOS)was used for quality evaluation of the literature,and Revman5.3 software was used for meta-analysis.Results: In our study,a total of 2,659 subjects were included in 32 literatures.The results showed that between PETD and PEID,the difference in operation time was statistically significant [MD=16.34(13.27,19.40),P < 0.05];the difference of intraoperative fluoroscopy times was statistically significant [SMD=13.74(3.07,4.41),P < 0.05];the difference in ODI score 3 months after surgery was statistically significant [MD=0.45(0.11,0.78),P < 0.05];there was no significant difference in ODI scores 6 months after surgery,[MD=-0.11(-0.73,0.51),P > 0.05];there was no significant difference in ODI scores 12 months after surgery [MD=-0.01(-0.33,0.31),P > 0.05];there was no significant difference in mean intervertebral height after surgery [MD=0.11(-0.29,0.51),P > 0.05];the difference of lumbar lordosis angle after operation was statistically significant [MD=0.94(0.31,1.57),P < 0.05];there was no significant difference in postoperative complications [RR=0.77(0.57,1.04),P > 0.05].Conclusions: 1.PETD with PEID in operation time,intraoperative fluoroscopy times are statistically significant.Using PEID might be more save time,can reduce radiation exposure.2.There was significant difference in ODI score between PETD and PEID at 3 months after operation,which may indicate that PEID can improve the short-term postoperative recovery.But the long-term recovery effect may be relatively consistent.3.There was statistical difference between PRTD and PEID in the postoperative lumbar lordosis angle.The recovery of lumbar lordosis after PETD may be relatively good.