TY - JOUR
T1 - Surgical Outcomes for Upper Lumbar Disc Herniations
T2 - A Systematic Review and Meta-analysis
AU - Echt, Murray
AU - Holland, Ryan
AU - Mowrey, Wenzhu
AU - Cezayirli, Phillip
AU - Ramos, Rafael De la Garza
AU - Hamad, Mousa
AU - Gelfand, Yaroslav
AU - Longo, Michael
AU - Kinon, Merritt D.
AU - Yanamadala, Vijay
AU - Chaudhary, Saad
AU - Cho, Samuel K.
AU - Yassari, Reza
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2021/6
Y1 - 2021/6
N2 - Study Design: Systematic review and meta-analysis. Objective: To conduct a literature review on outcomes of discectomy for upper lumbar disc herniations (ULDH), estimate pooled rates of satisfactory outcomes, compare open laminectomy/microdiscectomy (OLM) versus minimally invasive surgical (MIS) techniques, and compare results of disc herniations at L1-3 versus L3-4. Methods: A systematic review of articles reporting outcomes of nonfusion surgical treatment of L1-2, L2-3, and/or L3-4 disc herniations was performed. The inclusion and exclusion of studies was performed according to the latest version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: A total of 20 articles were included in the quantitative meta-analysis. Pooled proportion of satisfactory outcome (95% CI) was 0.77 (0.70, 0.83) for MIS and 0.82 (0.78, 0.84) for OLM. There was no significant improvement with MIS techniques compared with standard OLM, odds ratio (OR) = 0.86, 95% CI (0.42, 1.74), P =.66. Separating results by levels revealed a trend of higher satisfaction with L3-4 versus L1-3 with OLM surgery, OR = 0.46, 95% CI (0.19, 1.12), P =.08. Conclusion: Our analysis reveals that discectomy for ULDH has an overall success rate of approximately 80% and has not improved with MIS. Discectomy for herniations at L3-4 trends toward better outcomes compared with L1-2 and L2-3, but was not significant.
AB - Study Design: Systematic review and meta-analysis. Objective: To conduct a literature review on outcomes of discectomy for upper lumbar disc herniations (ULDH), estimate pooled rates of satisfactory outcomes, compare open laminectomy/microdiscectomy (OLM) versus minimally invasive surgical (MIS) techniques, and compare results of disc herniations at L1-3 versus L3-4. Methods: A systematic review of articles reporting outcomes of nonfusion surgical treatment of L1-2, L2-3, and/or L3-4 disc herniations was performed. The inclusion and exclusion of studies was performed according to the latest version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: A total of 20 articles were included in the quantitative meta-analysis. Pooled proportion of satisfactory outcome (95% CI) was 0.77 (0.70, 0.83) for MIS and 0.82 (0.78, 0.84) for OLM. There was no significant improvement with MIS techniques compared with standard OLM, odds ratio (OR) = 0.86, 95% CI (0.42, 1.74), P =.66. Separating results by levels revealed a trend of higher satisfaction with L3-4 versus L1-3 with OLM surgery, OR = 0.46, 95% CI (0.19, 1.12), P =.08. Conclusion: Our analysis reveals that discectomy for ULDH has an overall success rate of approximately 80% and has not improved with MIS. Discectomy for herniations at L3-4 trends toward better outcomes compared with L1-2 and L2-3, but was not significant.
KW - discectomy
KW - intervertebral disc degeneration
KW - intervertebral disc disease
KW - intervertebral disc displacement
KW - laminectomy
KW - odds ratio
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U2 - 10.1177/2192568220941815
DO - 10.1177/2192568220941815
M3 - Review article
AN - SCOPUS:85088983575
SN - 2192-5682
VL - 11
SP - 802
EP - 813
JO - Global Spine Journal
JF - Global Spine Journal
IS - 5
ER -