中国PETD和PEID治疗LDH手术并发症荟萃分析

A meta-analysis of complications from PETD and PEID in China

摘要:

目的：荟萃分析椎间孔入路椎间盘切除术和椎板间入路椎间盘切除术治疗椎间盘突出症的手术并发症。方法：通过中国知网,万方数据库,pubmed,NCBI等数据库,检索至2020年12月所有中国报道的椎间孔入路和椎板间入路经皮内窥镜椎间盘切除术治疗椎间盘突出症的对照研究。由两名研究人员独立进行相关研究数据提取和相关文献内容收集,并应用Revman5.3软件对所收集数据进行分析。结果：共纳入19篇文献,涉及1415例病例,其中PETD组700例,PEID组715例。分析结果显示PETD组和PEID组在术后感觉异常发生率(OR = 0.62,95％CI,0.34-1.13),神经根损伤率(OR = 0.99,95％CI,0.35-2.84),手术部位并发症发生率(OR = 0.88,95％CI,0.31-2.48),复发率(OR = 1.09,95％CI,0.55-2.15),转为开放性手术率(OR = 2.05,95％CI,0.37-11.45)和不完全减压发生率(OR = 2.95,95％CI,0.48-18.02)这几项指标相比无明显差异,而PETD组和PEID组相比,硬膜囊破裂率(OR = 0.35,95％CI,0.15-0.83)显著降低。结论：PETD和PEID手术安全性相近,但与PEID相比,PETD的硬膜囊破裂率显著降低。

Abstract:

Objective.:A meta-analysis of surgical complications of percutaneous endoscopic transforaminal discectomy and percutaneous endoscopic interlaminar discectomy in the treatment of lumbar disc herniation. Methods: Through CNKI, Wanfang database, PubMed, NCBI and other databases, all the control studies of percutaneous endoscopic discectomy with foraminal approach and interlaminar approach for disc herniation reported in China up to December 2020 were searched. Two researchers independently extracted relevant research data and collected relevant literature content, and analyzed the collected data with RevMan 5.3 software. Results: A total of 19 literatures were included, involving 1415 cases, including 700 cases in the PED group and 715 cases in the PEID group. Analysis results show that PETD and Reid group in the incidence of postoperative paraesthesia (OR = 0.62, 95% CI, 0.34 1.13), the nerve root injury rate (OR = 0.99, 95% CI, 0.35 2.84), the complication rate of surgical site (OR = 0.88, 95% CI, 0.31 2.48), the recurrence rate (OR = 1.09, 95% CI, 0.55 2.15), and converted to open surgery rate (OR = 2.05, 95% CI, 0.37-11.45) and the incidence of incomplete decompression (OR = 2.95, 95%CI, 0.48-18.02) were not significantly different, while the dural sac rupture rate (OR = 0.35, 95%CI, 0.15-0.83) was significantly lower in the PETD group than in the PEID group. Conclusion: The safety of PETD and PEID is similar, but the dural sac rupture rate of PETD is significantly lower than that of PEID.