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Systematic review of microendoscopic discectomy for lumbar disc herniation
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Smith, Nicholas A., Masters, James P. M., Jensen, Cyrus D., Khan, Almas and Sprowson, Andrew P. (2013) Systematic review of microendoscopic discectomy for lumbar disc herniation. European Spine Journal, Volume 22 (Number 11). pp. 2458-2465. doi:10.1007/s00586-013-2848-8 ISSN 0940-6719.
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Official URL: http://dx.doi.org/10.1007/s00586-013-2848-8
Abstract
Objective
To search and analyse randomised controlled trials (RCTs) published since the Cochrane review by Gibson and Waddell (2007) comparing microendoscopic discectomy (MED) with open discectomy (OD) or microdiscectomy (MD) and to assess whether MED improves patient-reported outcomes.
Summary of background
Discectomy for symptomatic herniated lumbar discs is an effective operative treatment. A number of operative techniques exist including OD, MD, and MED. A 2007 Cochrane review identified OD as an effective treatment for symptom improvement, and found sufficient evidence for MD. However, evidence for MED was lacking.
Methods
A systematic review of Medline and Embase was carried out. Aiming to identify RCTs carried out after 2007, which compared OD with MD and MED which reported the Oswestry disability index (ODI) as an outcome.
Results
Four RCTs were identified. None of the studies found a significant difference in the ODI scores between study groups at any time point. Three studies compared MED to OD and one compared OD, MD, and MED. The largest study reported an increased number of severe complications in the MED group.
Conclusions
There is some evidence to suggest that MED performed by surgeons skilled in the technique in tertiary referral centres is as effective as OD.
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > R Medicine (General) R Medicine > RC Internal medicine R Medicine > RD Surgery |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Systematic reviews (Medical research), Intervertebral disk -- Hernia -- Treatment -- Evaluation, Discectomy, Endoscopy | ||||
Journal or Publication Title: | European Spine Journal | ||||
Publisher: | Springer | ||||
ISSN: | 0940-6719 | ||||
Official Date: | 2013 | ||||
Dates: |
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Volume: | Volume 22 | ||||
Number: | Number 11 | ||||
Page Range: | pp. 2458-2465 | ||||
DOI: | 10.1007/s00586-013-2848-8 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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