1. Comparative Clinical Effectiveness of Tubular Microdiscectomy and Conventional Microdiscectomy for Lumbar Disc Herniation
- Author
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Wang Yinqing, Zeyan Liang, Tu Songjie, Chunmei Chen, and Jianfeng Wu
- Subjects
Reoperation ,medicine.medical_specialty ,Visual Analog Scale ,Visual analogue scale ,Network Meta-Analysis ,MEDLINE ,Intervertebral Disc Degeneration ,Spinal disease ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Orthopedics and Sports Medicine ,Postoperative Period ,Prospective Studies ,Prospective cohort study ,Randomized Controlled Trials as Topic ,030222 orthopedics ,Lumbar Vertebrae ,business.industry ,medicine.disease ,Surgery ,Oswestry Disability Index ,Treatment Outcome ,Systematic review ,Meta-analysis ,Neurology (clinical) ,business ,Intervertebral Disc Displacement ,030217 neurology & neurosurgery ,Diskectomy - Abstract
STUDY DESIGN This study is a systematic literature review and meta-analysis. OBJECTIVE To evaluate the efficacy of tubular microdiscectomy (TMD) compared with conventional microdiscectomy (CMD) for lumbar disc herniation (LDH). SUMMARY OF BACKGROUND DATA TMD has developed rapidly due to reduced tissue trauma by minimization of the required access to spine and disc herniation; however, CMD remains the standard of care for this patient group. To date, it remains debatable whether TMD is superior to CMD for LDH. METHODS We performed a comprehensive database search of PubMed, EMBASE, and Cochrane Central Register of Controlled Trails for prospective randomized controlled trials (RCTs), through using Medical Subject Headings (MeSH) terms "microdiscectomy," "tubular microdiscectomy," "minimally invasive surgery," and "spinal disease." The retrieved results were last updated on March 15, 2018. Two independent investigators selected qualified studies, extracted indispensable data, assessed risk of bias of original papers. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to grade quality of evidence. If I >50, the heterogeneity is considerable. RESULTS Four RCT studies (total n = 605), involving 610 individuals with a follow-up period of no less than 12 months, were selected for further review. We assessed these studies as low overall risk of bias. There was low-quality evidence that TMD was superior to CMD considering postoperative Oswestry Disability Index scores (SMD, -3.43, 95% CI, -4.64 to -2.21, P
- Published
- 2019