机构:[1]Capital Med Univ, Beijing Tongren Hosp, Dept Orthoped, Beijing, Peoples R China临床科室骨科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[2]Chinese Peoples Liberat Army Gen Hosp, Dept Orthoped, Beijing, Peoples R China
Background: Percutaneous transforaminal endoscopic discectomy (PTED) and micro-endoscopic discectomy (MED) are al- ternative minimally invasive, widely performed procedures for the treatment of lumbar disc herniation (LDH). This study compared the clinical outcomes of these 2 surgical techniques in treating LDH. Material/Methods: A comprehensive literature search was performed in PubMed, MEDLINE, EMBASE, Cochrane, and Google Scholar to identify all relevant studies comparing PTED and MED in treating LDH. Results: Eight comparative studies assessing a total of 805 patients were included for the final analysis. The results in- dicated that PTED needs a shorter incision [-1.02 (-1.21 to -0.83), p<0.001], less time in bed [-2.14 (-3.34 to -0.94), p<0.001], and shorter hospital stay [-1.92 (-2.90 to -0.94), p<0.001], whereas MED is superior regarding intraoperative fluoroscopy [7.47 (2.78 to 12.17), p=0.002] and total cost [0.69 (0.38 to 1.00), p<0.001]. No significant differences were found on operation time, intraoperative blood loss, or complications. Significant lower back pain was found in the PTED group at 1 week postoperatively [-0.52 (-0.95 to -0.10), p=0.02] and 1 year postoperatively or the last follow-up [-0.41 (-0.76 to -0.06), p=0.02]; significant lower leg pain was also detected at 1 week postoperatively [-0.52 (-0.75 to -0.30), p<0.001]. Oswestry Disability Index (ODI) was significant better at 1 week postoperatively in the PTED group [-4.41 (-7.03 to -1.79), p=0.001]. No significant differences were detected at other time points regarding pain score and ODI. Conclusions: Both PTED and MED are safe and effective techniques for treating LDH. However, taking all clinical outcomes together, PTED might be a preferable treatment modality for LDH.