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| YUAN Jiamin,ZHANG Hailong,GU Xin.Safety of minimally invasive lumbar discectomy: a meta-analysis[J].Chinese Journal of Spine and Spinal Cord,2012,(4):307-312. |
| Safety of minimally invasive lumbar discectomy: a meta-analysis |
| Received:July 30, 2011 Revised:October 10, 2011 |
| English Keywords:Lumbar disc herniation Discectomy Minimally invasive surgery Meta analysis |
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| English Abstract: |
| 【Abstract】 Objectives: To determine if the use of minimally invasive technique(including microendoscopic discectomy and microscopic discectomy) decreases safety. Methods： The Pubmed databases, Embase databases, the Cochrane Central Register of Controlled Trials, SinoMed databases and Wanfang Data(from 1997-01-01 to 2011-09-01), and also the reference lists of relevant reviews for eligible studies were searched. Rrandomized control trials comparing one-level microendoscopic discectomy and open discectomy in adults worldwide with prospective data collection. Two authors independently assessed trial quality and extracted data into an electrical sheet. Data of operation time, complications and blood loss from these studies were abstracted and synthesized by a meta-analysis with Revman 5.1.0. Results: 6 trials involving 773 adults metting our criteria were included for analysis. Comparing minimally invasive discectomy and open discectomy, the former was more likely to increase intraoperation complications[OR=1.53, 95%CI(0.79, 2.96)], have higher risk of recurrent herniation[OR=1.70, 95%CI(0.77, 3.79)] and dural tears[OR=1.00, 95%CI(0.38, 2.68)]. And the latter had higher risk of postoperation infection[OR=0.32, 95%CI(0.07, 1.35)], but all of these complications had no statistical difference（P>0.05）. The minimally invasive surgery spent more operation time[MD=18.03, 95%CI(5.84, 30.22)] with less blood loss[MD=-62.65, 95%CI(-102.56, -22.73)], and both had statistical differences(P<0.05). Conclusions: Compared with open discectomy, the minimally invasive surgery entails longer operation time and less blood loss, the rates of complications have no statistical difference. |
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