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

[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 disc herniation, 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。

[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.