Comparison of Full Endoscopic Lumbar Diskectomy Using the Transforaminal Approach versus Interlaminar Approach for L5–S1 Lumbar Disk Herniation Treatment: A Meta-Analysis

Ming-Tao Zhu; Bao-Shan Hu; Chien-Min Chen; Hong-Qi Liu; Guang-Xun Lin

doi:10.1055/a-2053-8365

Journal of Neurological Surgery Part A: Central European Neurosurgery, Inhaltsverzeichnis

J Neurol Surg A Cent Eur Neurosurg 2024; 85(05): 501-512
DOI: 10.1055/a-2053-8365

Review Article

Comparison of Full Endoscopic Lumbar Diskectomy Using the Transforaminal Approach versus Interlaminar Approach for L5–S1 Lumbar Disk Herniation Treatment: A Meta-Analysis

Ming-Tao Zhu^*

¹Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China

,

Bao-Shan Hu^*

²Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China

³The Third Clinical Medical College, The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, People's Republic of China

,

Chien-Min Chen^*

⁴Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan

⁵Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan

,

Hong-Qi Liu

⁶Department of Orthopedics, Zhangpu Country Hospital, Zhangzhou, People's Republic of China

³The Third Clinical Medical College, The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, People's Republic of China

,

Guang-Xun Lin

²Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China

³The Third Clinical Medical College, The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, People's Republic of China

› Institutsangaben

Abstract

Background Numerous studies have examined the clinical effectiveness of transforaminal full endoscopic lumbar diskectomy (T-FELD) and interlaminar full endoscopic lumbar diskectomy (I-FELD) for L5–S1 lumbar disk herniation (LDH), with mixed findings. The goal of this systematic review and meta-analysis was to evaluate the perioperative outcomes, clinical results, and complications of T-FELD and I-FELD to determine their efficacy and safety for treating L5–S1 LDH and to examine the features of complications in depth.

Methods Several databases were searched for articles that matched all of the inclusion criteria. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to assess the clinical results. Information on perioperative outcomes and complications was gathered and analyzed.

Results Eight studies with 756 participants were included. There were no significant differences in postoperative bed time (p = 0.44) and hospitalization time (p = 0.49) between T-FELD and I-FELD. When compared with I-FELD, T-FELD was associated with substantially longer fluoroscopy time (p < 0.0001) and operating time (p < 0.0001). There were no significant differences in the preoperative and postoperative VAS and ODI scores between T-FELD and I-FELD. The rates for overall complications, postoperative dysesthesia, postoperative lower extremity pain, incomplete decompression, recurrence, and conversion to open surgery were comparable for T-FLED and I-FELD.

Conclusion T-FELD and I-FELD had equal clinical results and safety for treatment of L5–S1 LDH. Fluoroscopy and operative times were shorter for I-FELD than for T-FELD.

Keywords

full endoscopic lumbar diskectomy - transforaminal - interlaminar - L5–S1 - lumbar disk herniation

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Referenzen

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