A Meta Analysis Of Microendoscopic Discectomy Versus Open Discectomy Treatment In Patients With Lumbar Disc Herniation

ObjectiveTo assess the effects of MED and OD treatment of the LDH by meta analysis.MethodsData sources were studies identified by using the Pubmed Medline database. CNKI and WanFang database, scanning of the relevant reference lists.The key words were "Microendoscopic discectomy", "Open discectomy", "Minimally invasive surgery" and "Lumbar disc herniation". We used fixed effect model or random effect model of meta analysis with RevMan4.2 software.ResultsWe pooled and analysised 6 control studies comparing MED with OD treatment of LDH, including a total of 673 patients. We found there was no significant difference in the excellent and good rate (OR=1.70,95%CI (0.91,2.24), P=0.94,homogeneity, P=0.09). There was no significant difference in the complications (OR=0.63,95%CI (0.24,1.67), P=0.44 homogeneity, P=0.36).There was no significant difference in the mean operation time (WMD=-4.48,95%CI (-24.54,15.57), P＜0.00001 heterogeneity (random effect model), P=0.66).But we found there was significant difference in the mean blood loss (WMD=-94.72,95%CI (-164.16,-25.28), P<0.00001 heterogeneity (random effect model), P=0.008);and in the mean time in bed (WMD=-6.14,95%CI (-11.28,-1.01), P<0.00001 heterogeneity (random effect model), P=0.02) ConclusionThe MED treatment was no better than OD in the excellent and good rate, the complications and in the mean operation time. But it can reduce the mean blood loss and the mean time in bed of the patients significantly. Besides, due to the lack of Evidence-based guidelines for the treatment of LDH, the results which indicated above need further study.