经皮全内镜经椎间孔入路（PETD）与经椎板间入路（PEID）治疗钙化型腰椎间盘突出症的疗效荟萃分析

A meta-analysis of the efficacy of percutaneous endoscopic transforaminal approach (PETD) and translaminar approach (PEID) in the treatment of calcified lumbar disc herniation

摘要:

[目的] 系统评价经椎间孔（percutaneous endoscopic transforaminal discectomy, PETD）与经椎板间（percutaneous endoscopic interlaminar discectomy, PEID）入路内镜切除钙化型椎间盘突出症（calcified lumbar disc herniation, cLDH）的疗效比较。[方法] 检索1973年1月至2023年2月PubMed，Web of science、EMSCO、CNKI、万方、维普数据库，搜集PETD与PEID治疗cLDH疗效文献。依据纳入和排除标准筛选文献，并进行质量评价和资料提取，Revman 5.4 软件进行荟萃分析。[结果] 共纳入英文文献2篇，中文文献1篇。包括PETD治疗89例，PEID治疗72例。荟萃分析结果显示：治疗前和末次随访时下肢VAS评分、ODI评分比较，经椎板间组和经椎间孔组均现在显著改善，差异具有统计学意义（P<0.05）；年龄、性别、病程、下肢VAS评分、腰椎功能障碍指数（ODI）、术后优良率Modified评分、术后并发症等比较，经椎板间组和经椎间孔组之间比较不具有统计学差异（P>0.05）。[结论] PEID和PETD均可有效治疗钙化型腰椎间盘突出症，PEID和PETD之间疗效和并发症发生率比较无差异。

Abstract:

[Objective] To systematically evaluate the efficacy of percutaneous endoscopic transforaminal (PETD) and translaminar (PEID) approaches in the treatment of calcified lumbar disc herniation (cLDH). [Methods] From January 1973 to February 2023, PubMed, Web of science, EMSCO, CNKI, Wanfang and VIP databases were searched to collect literatures on the efficacy of PETD and PEID in the treatment of cLDH. References were screened according to inclusion and exclusion criteria, and quality assessment and data extraction were performed. Meta-analysis was performed by Revman 5.4 software. [Results] A total of 2 English literatures and 1 Chinese literature were included. PETD treated 89 cases and PEID treated 72 cases. The results of meta-analysis showed that the lower extremity VAS score and ODI score were significantly improved in the PEID group and the PETD group before treatment and at the last follow-up, and the difference was statistically significant (P<0.05); There was no significant difference between PEID and PETD groups in age, sex, disease course, lower extremity VAS score, lumbar spine dysfunction index (ODI), Modified score of postoperative good and good rate, and postoperative complications (P>0.05). [Conclusion] Both PEID and PETD can effectively treat calcified lumbar disc herniation, and there is no difference in efficacy and complication rate between the two groups.