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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   *
1   Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China
,
Bao-Shan Hu   *
2   Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China
3   The Third Clinical Medical College, The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
,
Chien-Min Chen   *
4   Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
5   Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan
,
Hong-Qi Liu
6   Department of Orthopedics, Zhangpu Country Hospital, Zhangzhou, People's Republic of China
3   The Third Clinical Medical College, The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
,
Guang-Xun Lin
2   Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China
3   The Third Clinical Medical College, The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
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Funding This research was funded by the “Natural Science Foundation of Fujian Province, grant number 2021J05282 ”; funded by Xiamen Municipal Bureau of Science and Technology (3502Z20224033); funded by the “Xiamen Health System Discipline Leaders and their Backup Candi-dates, Senior Management Talent Training Candidates Training Program (2021) ”; funded by the “Ningxia Jingyuan County Science and Technology Planning Bureau (2022) ”. The funder had no role in the design of the study or collection, analysis, or interpretation of data or in writing the manuscript.
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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

* These authors have contributed equally to this work.




Publikationsverlauf

Eingereicht: 04. Mai 2022

Angenommen: 07. März 2023

Accepted Manuscript online:
14. März 2023

Artikel online veröffentlicht:
24. August 2023

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