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J Orthop Surg Res. 2018 Jul 5;13(1):169. doi: 10.1186/s13018-018-0868-0.

Transforaminal endoscopic discectomy versus conventional microdiscectomy for lumbar discherniation: a systematic review and meta-analysis.

Author information

1
Department of Orthopedics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, People's Republic of China.
2
Department of Orthopedics, First Affiliated Hospital of Gannan Medical University General Hospital, No. 23 Qingnian Road, Zhanggong District, Ganzhou, 341000, People's Republic of China.
3
Department of Orthopedics, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, People's Republic of China. sqfeng@tmu.edu.cn.

Abstract

BACKGROUND:

The open microdiscectomy is the most common surgical procedure for the decompression of radiculopathy caused by lumbar disk herniation. To date, a variety of minimally invasive (MI) techniques have been developed. In the last decades, endoscopic techniques have been developed to perform discectomy. The transforaminal endoscopic discectomy (TED) with posterolateral access evolved out of the development of endoscopic techniques.

METHODS:

A systematic literature search was performed using the PubMed, EMBASE, and Cochrane Library databases for trials written in English. The randomized trials and observational studies that met our inclusion criteria were subsequently included. Two reviewers respectively extracted data and estimated the risk of bias. All statistical analyses were performed using Review Manager 5.3.

RESULTS:

Five prospective and four retrospective studies involving 1527 patients were included. The results of the meta-analysis indicated that there were significant differences between the two groups in length of hospital stay (MD = - 8.41, 95% CI - 10.26, - 6.56; p value <‚ÄČ0.00001). However, there were no significant differences in the leg visual analog scale (VAS) scores, the Oswestry Disability Index (ODI) scores, and the incidence of complications and recurrence.

CONCLUSIONS:

The transforaminal endoscopic discectomy is superior to open microdiscectomy in the length of hospital stay. However, there were no differences in leg pain, functional recovery, and incidence of complications between TED and MD in treating LDH.

KEYWORDS:

Conventional microdiscectomy; Meta-analysis; Transforaminal endoscopic discectomy

PMID:
29976224
PMCID:
PMC6034279
DOI:
10.1186/s13018-018-0868-0
[Indexed for MEDLINE]
Free PMC Article

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