Comparison of percutaneous endoscopic cervical discectomy versus anterior cervical discectomy and fusion for cervical disc herniation:a meta-analysis  

作　　者：李庆达 章雪芳 杨俊松 Chen Chienmin Liu Tuanjiang He Baorong Jiang Chao Tian Xin Yang Mingyi Chai Xin Tuo Yuan Hao Dingjun Li Qingda;Zhang Xuefang;Yang Junsong;Chen Chienmin;Liu Tuanjiang;He Baorong;Jiang Chao;Tian Xin;Yang Mingyi;Chai Xin;Tuo Yuan;Hao Dingjun(Department of Spinal Surgery,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054;Medical School of Yan'an University,Yan'an 716000;Division of Neurosurgery,Department of Surgery,Changhua Christian Hospital,Changhua,Taiwan;School of Medicine,Kaohsiung Medical University,Kaohsiung,Taiwan;College of Nursing and Health Sciences,Dayeh University,Taiwan;The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710000,China)

机构地区：[1]Department of Spinal Surgery,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054 [2]Medical School of Yan'an University,Yan'an 716000 [3]Division of Neurosurgery,Department of Surgery,Changhua Christian Hospital,Changhua,Taiwan [4]School of Medicine,Kaohsiung Medical University,Kaohsiung,Taiwan [5]College of Nursing and Health Sciences,Dayeh University,Taiwan [6]The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710000,China

出　　处：《美中国际创伤杂志》2021年第2期18-26,31,共10页U.S.Chinese International Journal of Traumatology

摘　　要：Purpose:The purpose of the study is to perform a systematic review and meta-analysis to evaluate the clinical results of percutaneous endoscopic cervical discectomy(PECD)and anterior cervical discectomy and fusion(ACDF)for the treatment of cervical disc herniation(CDH).Methods:Randomized controlled trials or non-randomized controlled trials published from the time when databases were built to October 2020 that compared the clinical effectiveness of PECD and ACDF surgical approaches for the treatment of CDH were acquired hy a comprehensive search in four electronic databases(Pub Med,EMBASE,and Web of Science).A total of 5 studies(559 patients)were included in this systematic review and meta-analysis.Pooled mean differences(MD)and odds ratios(OR)and with 95% CIs were calculated for the outcomes.Results:The results showed that there were no statistically between the PECD group and ACDF group in terms of preoperative VASN score(WMD=0.22;95%CI:-0.52 to 0.97;P=0.56),preoperative VASA score(WMD=-0.13;95%CI:-0.42 to 0.16;P=0.37),postoperative VASN score(WMD=0.14;95%CI:-0.12 to 0.40;P=0.28),postoperative VASA score(WMD=-0.08;95%CI:-0.28 to 0.11;P=0.40),preoperative NDI(WMD=-0.75;95%CI:-5.60 to 4.11;P=0.76),postoperative NDI(WMD=0.22;95%CI:-1.44 to 1.88;P=0.80),,reoperation rate(OR=1.35;95%CI:0.49 to 3.72;P=0.57)or operation time(WMD=-11.76;95%CI:-71.23 to 47.72;P=0.70).PECD group was associated with lower complication rate(OR=0.34;95%CI:0.15 to 0.78;P=0.01)and shorter hospital stay(WMD=-2.59;95%CI:-3.67 to -1.52;P<0.00001).Conclusion:The existing evidence indicates that no superiority exists between the two surgical approaches for the treatment of CDH in terms of functional outcome,operation lime,and reoperation rate,despite that PECD surgical group can achieve lower complication rates and shorter hospital stay than ACDF surgical group.

关 键 词：Cervical disc herniation MICRODISCECTOMY Treatment outcome SURGERY PERCUTANEOUS Endoscopic cervical discectomy Anterior approach Posterior approach 

分 类 号：R68[医药卫生—骨科学]