经椎间孔与椎板间内镜切除钙化椎间盘突出荟萃分析△

A meta-analysis on transforaminal and interlaminal endoscopic discectomies for calcified lumbar disc herniation

摘要:

[目的] 采用荟萃分析评价经椎板间内镜椎间盘切除（percutaneous endoscopic interlaminar discectomy, PEID） 与经椎间孔内镜椎间盘切除（percutaneous endoscopic transforaminal discectomy, PETD） 治疗钙化型椎间盘突出症（calcified lumbar discherniation, cLDH） 的疗效。[方法] 检索1973 年1 月—2023 年2 月PubMed, Web of science, EMSCO, CNKI 及万方、维普数据库，搜集PEID 与PETD 治疗cLDH 疗效文献。采用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。共纳入病例161 例，其中PEID 治疗72 例，PETD 治疗89 例。荟萃分析结果显示：与治疗前相比，末次随访时两组下肢VAS 评分[PEID 组(MD=6.58, 95% CI 4.65~8.51, P＜0.001); PETD 组(MD=6.40, 95% CI 4.72~8.07, P＜0.001)]、ODI 评分[PEID 组(MD=53.39, 95%CI 50~56.78, P＜0.001); PETD 组(MD=52.34, 95%CI 48.73~55.96, P＜0.001)] 均显著改善。两组末次随访时下肢VAS、ODI 评分及Modified 评分优良率、术后并发症发生率比较的差异均无统计学意义（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差异无统计学意义。

关键词:钙化型腰椎间盘突出症;经椎板间内镜椎间盘切除;经椎间孔内镜椎间盘切除;荟萃分析

Abstract:

[Objective] To evaluate the clinical efficacy of percutaneous endoscopic interlaminar discectomy (PEID) versus percutane-ous endoscopic transforaminal discectomy (PETD) for calcified lumbar disc herniation (cLDH). [Methods] PubMed, Web of science, EMS-CO, CNKI and Wanfang and VIP databases from January 1973 to February 2023 were searched to collect literatures on the comparison ofPETD and PEID in the treatment of cLDH. A meta-analysis was performed with Revman 5.4 software. [Results] A total of 2 English litera-tures and 1 Chinese literatures were included in this study, involving a total of 161 patients, 72 treated with PEID and 89 with PETD. As re-sults of the meta-analysis, the leg pain VAS scores [PEID group, (MD=6.58, 95%CI 4.65~8.51, P＜0.001); PETD group, (MD=6.40, 95%CI4.72~8.07, P＜0.001)], and ODI score [PEID group, (MD=53.39, 95% CI 50~56.78, P＜0.001); PETD group (MD=52.34, 95% CI 48.73~55.96, P＜0.001)] were significantly improved at the latest follow-up compared with those preoperatively. However, there were no significantdifferences in VAS, ODI score, modified score and postoperative complication rate between the two groups at the last follow-up (P＞0.05).[Conclusion] Both PEID and PETD can effectively treat calcified lumbar disc herniation, and there is no significant difference in efficacyand complication rate between PEID and PETD.

Key words:calcified lumbar disc herniation; percutaneous endoscopic interlaminar discectomy (PEID); percutaneous endoscopictransforaminal discectomy (PETD); meta-analysis