Journal article
Complication rates of different discectomy techniques for the treatment of lumbar disc herniation: a network meta-analysis
European spine journal, Vol.28, pp.2588-2601
11/2019
PMID: 31529215
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Source: InCites
Abstract
Purpose
The aim of this network meta-analysis (NMA) was to compare the complication rates of discectomy/microdiscectomy, percutaneous laser disc decompression (PLDD), percutaneous endoscopic lumbar discectomy (PELD), microendoscopic discectomy (MED), and tubular discectomy for symptomatic lumbar disc herniation (LDH).
Methods
We searched three online databases for randomized controlled trials (RCTs). Overall complication rates, complication rates per general and modified Clavien–Dindo classification schemes, and reoperation rates were considered as primary outcomes. Odds ratio with 95% confidence intervals for direct comparisons and 95% credible intervals for NMA results were reported. Surface under cumulative ranking curve (SUCRA) was used to estimate ranks for each discectomy technique based on the complication rates.
Results
In total, 18 RCTs with 2273 patients were included in this study. Our results showed that there was no significant difference in any of the pairwise comparisons. PELD (SUCRA: 0.856) ranked the lowest for overall complication rates. Discectomy/microdiscectomy (SUCRA: 0.599) and PELD (SUCRA: 0.939) ranked the lowest for intraoperative and post-operative complication rates, respectively. Concerning modified Clavien–Dindo classification scheme, PELD (SUCRA: 0.803), MED (SUCRA: 0.730), and PLDD (SUCRA: 0.605) ranked the lowest for the occurrence of type I, II, and III complications, respectively. Tubular discectomy (SUCRA: 0.699) ranked the lowest for reoperation rates.
Conclusions
The results of this NMA suggest that discectomy/microdiscectomy and PELD are the safest procedures for LDH with minimal intraoperative and post-operative complications, respectively. PELD, MED, and PLDD are the safest procedures for LDH in terms of minimal rates for complications necessitating conservative, pharmacological, and surgical treatment, respectively.
Details
- Title
- Complication rates of different discectomy techniques for the treatment of lumbar disc herniation: a network meta-analysis
- Creators
- Xiaolong Chen - University of New South WalesUphar Chamoli - University of Technology SydneySamuel Lapkin - University of WollongongJose Vargas Castillo - University of New South WalesAshish D. Diwan - University of New South Wales
- Publication Details
- European spine journal, Vol.28, pp.2588-2601
- Publisher
- Springer Nature
- Number of pages
- 14
- Grant note
- International Society for the Study of the Lumbar Spine (ISSLS) in 2018 University Postgraduate Award from the Australian Government Research Training Program scholarship from the Australian Government UNSW
- Identifiers
- 991013092672402368
- Copyright
- © Springer-Verlag GmbH Germany, part of Springer Nature 2019.
- Academic Unit
- Faculty of Health
- Language
- English
- Resource Type
- Journal article