Meta-Analysis on Microdiscectomy and Sequestrectomy for Lumbar Disc Herniation

ABSTRACT

Purpose: Lumbar disc herniation (LDH) is a common cause of low back pain and mainly occurs in patients aged 24 to 45 years. To further compare the efficacy of microdiscectomy and sequestrectomy, we made quantitative evaluation of clinical studies published so far by meta-analysis in order to provide information for clinical decision. Methods: Literatures reporting randomized controlled studies that compared the efficacy of microdiscectomy and sequestrectomy for LDH were retrieved from major databases using predefined inclusion and exclusion criteria. Results: Meta-analysis showed that microdiscectomy resulted in higher low back pain VAS score (standard mean difference, SMD = 0.86, 95% confidential interval, CI: 0.19, 1.53; P = 0.01) and there was not statistically significant difference in the incidence of re-operation (odd ratio, OR = 0.85, 95% CI: 0.46, 1.85; P = 0.60) and neuropathic pain VAS scores (SMD = 0.51, 95% CI: −0.16, 1.18; P = 0.14) between the methods. Conclusion: Both microdiscectomy and sequestrectomy had good curative results in the treatment of LDH. In low back pain VAS score, the former was better than the latter, while in the analgesic usage rate, the latter was superior to the former. In clinical practice, the choice of surgical method should be considered on the basis of actual situations.

Keywords: :

• lumbar disc herniation (LDH)
• microdiscectomy
• sequestrectomy
• Meta-analysis