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Open Versus Minimally Invasive Surgical procedure for Extraforaminal Lumbar Disk Herniation: A Systematic Evaluation and Meta-Evaluation.

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Open Versus Minimally Invasive Surgical procedure for Extraforaminal Lumbar Disk Herniation: A Systematic Evaluation and Meta-Evaluation.

World Neurosurg. 2017 Dec;108:924-938.e3

Authors: Akinduro OO, Kerezoudis P, Alvi MA, Yoon JW, Eluchie J, Murad MH, Wang Z, Chen SG, Bydon M

INTRODUCTION: Extraforaminal disk herniation (EDH) accounts for three%-11% of all disk herniations. Regardless of the heterogeneity of spinal procedures, there’s a paucity of literature evaluating the outcomes from completely different surgical approaches.
METHODS: We carried out a scientific evaluate and meta-analysis of obtainable literature on EDHs. We in contrast sufferers present process open surgical procedure (OS) with these present process minimally invasive surgical procedure (MIS) approaches, together with tubular microscopic, percutaneous endoscopic, and microendoscopic.
RESULTS: A complete of 41 research with 1813 sufferers (1239 OS, 574 MIS) had been included our evaluation. The MIS group confirmed no vital distinction from OS group within the incidence of problems (MIS: zero.01 vs. OS: zero.01, P = zero.971) or reoperation (OS: zero.04, MIS: zero.03; P = zero.382). There was an elevated incidence of poor affected person satisfaction in line with the Macnab standards for the OS group in contrast with the MIS group, however the distinction was not statistically vital (OS: zero.14 vs. MIS: zero.06; P = zero.237). The OS group had better estimated blood loss (imply distinction [MD]: 38.6 mL), barely longer operation time (MD: 12.2 minutes), longer hospital keep (MD: 30.three hours), and longer return to work time (MD: three.three weeks). Tubular microscopic procedures had a decrease incidence of reoperation than each percutaneous endoscopic (zero.01 vs. zero.06, P = zero.01) and microendoscopic procedures (zero.01 vs. zero.05, P = zero.03).
CONCLUSIONS: Minimally invasive procedures for EDHs are related to an analogous incidence of problems and reoperation however decrease estimated blood loss, shorter operative time, shorter hospital keep, and sooner return to work time in comparison with OS. Tubular microscopic have the bottom reoperation price of MIS procedures.

PMID: 28803171 [PubMed – indexed for MEDLINE]

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