Clinical outcomes and safety of visual trephine-assisted percutaneous endoscopic transforaminal discectomy for treatment of lumbar disc herniation:a meta-analysis
Objective:To systematically review the clinical outcomes and safety of visual trephine-assisted percutaneous endoscopic transforaminal discectomy(PETD)in treatment of lumbar disc herniation(LDH).Methods:All the randomized controlled trial(RCT)arti-cles and retrospective clinical trial articles about the clinical outcomes and safety of visual trephine versus traditional trephine-assisted PETD for treatment of LDH included from database's inception to November 30,2023 were retrieved from the China National Knowledge Infrastructure,Wanfang Database,Vip Database,Chinese Biomedical Literature Service System,PubMed,Embase and Cochrane Library.The pertinent articles were screened,the information was extracted and the methodological quality of the included researches in the articles was assessed independently by two researchers,and then a Meta-analysis was conducted by using RevMan5.3 software.Results:Ten articles were included in the final analysis,including 2 RCT articles and 8 retrospective clinical trial articles,with 377 patients in visual trephine group and 379 ones in traditional trephine group.The results of Meta-analysis revealed that the operative time was shorter,intraoperative X-ray exposure was fewer,intraoperative blood loss was less,and leg pain relieved more significantly in visual trephine group compared to traditional trephine group(MD=-10.40,95％CI(-12.08,-8.71),P=0.000;MD=-6.67,95％CI(-6.94,-6.40),P=0.000;MD=-2.22,95％CI(-3.56,-0.89),P=0.001;MD=-0.28,95％CI(-0.43,0.14),P=0.000),while,there was no statistical difference in Oswestry disability index(ODI),low back pain visual analogue scale(VAS)score,Japanese Orthopedic Association(JOA)low back pain efficacy score,postoperative excellent and good rate of efficacy,as well as postoperative complication incidence rate between the 2 groups.Conclusion:Available evidences suggest that,compared to the traditional trephine-assisted PETD,the visual trephine-assisted PETD can shorten the operative time,reduce intraoperative X-ray exposure and blood loss,as well as alleviate the leg pain in treatment of LDH.
intervertebral disc displacementlumbar vertebraediskectomy,percutaneousendoscopyvisual trephinemeta-analysis as topic
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