Comparison of 7 Surgical Interventions for Lumbar Disc Herniation: A Network Meta-analysis
The number of interventions on intervertebral discs rapidly increased and the treatment options for lumbar disc surgery quickly evolved. It is important that the safety and efficacy of all new innovative procedures be compared with currently accepted forms of treatment; however, the previous pairwis...
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| Veröffentlicht in: | Pain physician 2017-09, Vol.20 (6), p.E863-E871 |
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| creator | Feng, Fan Xu, Qianqian Yan, Feifei Xie, Yuanlong Deng, Zhouming Hu, Chao Zhu, Xiaobin Cai, Lin |
| description | The number of interventions on intervertebral discs rapidly increased and the treatment options for lumbar disc surgery quickly evolved. It is important that the safety and efficacy of all new innovative procedures be compared with currently accepted forms of treatment; however, the previous pairwise meta-analyses could not develop the hierarchy of these treatments.
The purpose of the study is to perform a network meta-analysis to evaluate the clinical results of 7 surgical interventions for the treatment of lumbar disc herniation.
Network meta-analysis of randomized controlled trials (RCTs) for multiple treatment comparisons of lumbar disc herniation.
We performed a Bayesian-framework network meta-analysis of RCTs to compare 7 surgical interventions for people with lumbar disc herniation. The eligible RCTs were identified by searching Embase, Pubmed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google scholar. Data from 3 outcomes (success, complications, and reoperation rate) were independently extracted by 2 authors.
A total of 29 RCTs including 3,146 participants were finally included into this article. Our meta-analysis provides hierarchies of these 7 interventions. For the success rate the rank probability (from best to worst): percutaneous endoscopic lumber discectomy (PELD) > standard open discectomy (SOD) > standard open microsurgical discectomy (SOMD) > chemonucleolysis (CN) > microendoscopic discectomy (MED) > percutaneous laser disc decompression (PLDD) > automated percutaneous lumber discectomy (APLD). For the complication rate the rank probability (from best to worst): PELD > SOMD > SOD > MED > PLDD > CN > APLD. For the reoperation rate the rank probability (from best to worst): SOMD > SOD > MED > PLDD > PELD > CN > APLD.
The limitations of this network meta-analysis include the range of study populations and inconformity of the follow-up times and outcome measurements.
This meta-analysis provides evidence that PELD might be the best choice to increase the success rate and decrease the complication rate, moreover SOMD might be the best option to drop the reoperation rate. APLD might lead to the lowest success rate and the highest complication and reoperation rate. Higher quality RCTs and direct head to head trials are needed to confirm these results.Key words: Lumbar disc herniation, discectomy, minimally invasive surgery, network meta-analysis. |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1942677888</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1942677888</sourcerecordid><originalsourceid>FETCH-LOGICAL-p154t-89471d89391a7131c31924f099176819e516d7e64f3722e6ada83b012a0c69f83</originalsourceid><addsrcrecordid>eNpdkDtPwzAYRS0EoqXwF5AlFpZI_vw2W1UerVRgABaWyE0c5JLEwU5A_fcEURamO9yjq6N7gKYUBMkAuDlEUxCMZQyEmaCTlLaEMGkMO0YTqg3jmvApel2EprPRp9DiUGGFn4b45gtb41Xbu_jp2t6HNuEqRLwemo2N-NqnAi9dbL396a7wHD-4_ivEd3zvepvZ1ta75NMpOqpsndzZPmfo5fbmebHM1o93q8V8nXUgeJ9pwxWUo5ABq4BBwcBQXhFjQEkNxgmQpXKSV0xR6qQtrWYbAtSSQppKsxm6_N3tYvgYXOrzZjR0dW1bF4aUg-FUKqX1D3rxD92GIY6-KadSSAKghRip8z01bBpX5l30jY27_O819g0oxGcp</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2656011855</pqid></control><display><type>article</type><title>Comparison of 7 Surgical Interventions for Lumbar Disc Herniation: A Network Meta-analysis</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Feng, Fan ; Xu, Qianqian ; Yan, Feifei ; Xie, Yuanlong ; Deng, Zhouming ; Hu, Chao ; Zhu, Xiaobin ; Cai, Lin</creator><creatorcontrib>Feng, Fan ; Xu, Qianqian ; Yan, Feifei ; Xie, Yuanlong ; Deng, Zhouming ; Hu, Chao ; Zhu, Xiaobin ; Cai, Lin</creatorcontrib><description>The number of interventions on intervertebral discs rapidly increased and the treatment options for lumbar disc surgery quickly evolved. It is important that the safety and efficacy of all new innovative procedures be compared with currently accepted forms of treatment; however, the previous pairwise meta-analyses could not develop the hierarchy of these treatments.
The purpose of the study is to perform a network meta-analysis to evaluate the clinical results of 7 surgical interventions for the treatment of lumbar disc herniation.
Network meta-analysis of randomized controlled trials (RCTs) for multiple treatment comparisons of lumbar disc herniation.
We performed a Bayesian-framework network meta-analysis of RCTs to compare 7 surgical interventions for people with lumbar disc herniation. The eligible RCTs were identified by searching Embase, Pubmed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google scholar. Data from 3 outcomes (success, complications, and reoperation rate) were independently extracted by 2 authors.
A total of 29 RCTs including 3,146 participants were finally included into this article. Our meta-analysis provides hierarchies of these 7 interventions. For the success rate the rank probability (from best to worst): percutaneous endoscopic lumber discectomy (PELD) > standard open discectomy (SOD) > standard open microsurgical discectomy (SOMD) > chemonucleolysis (CN) > microendoscopic discectomy (MED) > percutaneous laser disc decompression (PLDD) > automated percutaneous lumber discectomy (APLD). For the complication rate the rank probability (from best to worst): PELD > SOMD > SOD > MED > PLDD > CN > APLD. For the reoperation rate the rank probability (from best to worst): SOMD > SOD > MED > PLDD > PELD > CN > APLD.
The limitations of this network meta-analysis include the range of study populations and inconformity of the follow-up times and outcome measurements.
This meta-analysis provides evidence that PELD might be the best choice to increase the success rate and decrease the complication rate, moreover SOMD might be the best option to drop the reoperation rate. APLD might lead to the lowest success rate and the highest complication and reoperation rate. Higher quality RCTs and direct head to head trials are needed to confirm these results.Key words: Lumbar disc herniation, discectomy, minimally invasive surgery, network meta-analysis.</description><identifier>ISSN: 1533-3159</identifier><identifier>EISSN: 2150-1149</identifier><identifier>PMID: 28934804</identifier><language>eng</language><publisher>United States: American Society of Interventional Pain Physician</publisher><subject>Decompression, Surgical - methods ; Decompression, Surgical - standards ; Diskectomy - methods ; Diskectomy - standards ; Diskectomy, Percutaneous - methods ; Diskectomy, Percutaneous - standards ; Endoscopy - methods ; Endoscopy - standards ; Humans ; Intervertebral Disc - diagnostic imaging ; Intervertebral Disc - surgery ; Intervertebral Disc Degeneration - diagnostic imaging ; Intervertebral Disc Degeneration - surgery ; Intervertebral Disc Displacement - diagnostic imaging ; Intervertebral Disc Displacement - surgery ; Laser discs ; Lumbar Vertebrae - diagnostic imaging ; Lumbar Vertebrae - surgery ; Meta-analysis ; Minimally Invasive Surgical Procedures - methods ; Minimally Invasive Surgical Procedures - standards ; Network Meta-Analysis ; Randomized Controlled Trials as Topic - methods ; Reoperation - methods ; Reoperation - standards ; Success</subject><ispartof>Pain physician, 2017-09, Vol.20 (6), p.E863-E871</ispartof><rights>2017. This work is published under https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28934804$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Feng, Fan</creatorcontrib><creatorcontrib>Xu, Qianqian</creatorcontrib><creatorcontrib>Yan, Feifei</creatorcontrib><creatorcontrib>Xie, Yuanlong</creatorcontrib><creatorcontrib>Deng, Zhouming</creatorcontrib><creatorcontrib>Hu, Chao</creatorcontrib><creatorcontrib>Zhu, Xiaobin</creatorcontrib><creatorcontrib>Cai, Lin</creatorcontrib><title>Comparison of 7 Surgical Interventions for Lumbar Disc Herniation: A Network Meta-analysis</title><title>Pain physician</title><addtitle>Pain Physician</addtitle><description>The number of interventions on intervertebral discs rapidly increased and the treatment options for lumbar disc surgery quickly evolved. It is important that the safety and efficacy of all new innovative procedures be compared with currently accepted forms of treatment; however, the previous pairwise meta-analyses could not develop the hierarchy of these treatments.
The purpose of the study is to perform a network meta-analysis to evaluate the clinical results of 7 surgical interventions for the treatment of lumbar disc herniation.
Network meta-analysis of randomized controlled trials (RCTs) for multiple treatment comparisons of lumbar disc herniation.
We performed a Bayesian-framework network meta-analysis of RCTs to compare 7 surgical interventions for people with lumbar disc herniation. The eligible RCTs were identified by searching Embase, Pubmed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google scholar. Data from 3 outcomes (success, complications, and reoperation rate) were independently extracted by 2 authors.
A total of 29 RCTs including 3,146 participants were finally included into this article. Our meta-analysis provides hierarchies of these 7 interventions. For the success rate the rank probability (from best to worst): percutaneous endoscopic lumber discectomy (PELD) > standard open discectomy (SOD) > standard open microsurgical discectomy (SOMD) > chemonucleolysis (CN) > microendoscopic discectomy (MED) > percutaneous laser disc decompression (PLDD) > automated percutaneous lumber discectomy (APLD). For the complication rate the rank probability (from best to worst): PELD > SOMD > SOD > MED > PLDD > CN > APLD. For the reoperation rate the rank probability (from best to worst): SOMD > SOD > MED > PLDD > PELD > CN > APLD.
The limitations of this network meta-analysis include the range of study populations and inconformity of the follow-up times and outcome measurements.
This meta-analysis provides evidence that PELD might be the best choice to increase the success rate and decrease the complication rate, moreover SOMD might be the best option to drop the reoperation rate. APLD might lead to the lowest success rate and the highest complication and reoperation rate. Higher quality RCTs and direct head to head trials are needed to confirm these results.Key words: Lumbar disc herniation, discectomy, minimally invasive surgery, network meta-analysis.</description><subject>Decompression, Surgical - methods</subject><subject>Decompression, Surgical - standards</subject><subject>Diskectomy - methods</subject><subject>Diskectomy - standards</subject><subject>Diskectomy, Percutaneous - methods</subject><subject>Diskectomy, Percutaneous - standards</subject><subject>Endoscopy - methods</subject><subject>Endoscopy - standards</subject><subject>Humans</subject><subject>Intervertebral Disc - diagnostic imaging</subject><subject>Intervertebral Disc - surgery</subject><subject>Intervertebral Disc Degeneration - diagnostic imaging</subject><subject>Intervertebral Disc Degeneration - surgery</subject><subject>Intervertebral Disc Displacement - diagnostic imaging</subject><subject>Intervertebral Disc Displacement - surgery</subject><subject>Laser discs</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Meta-analysis</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Minimally Invasive Surgical Procedures - standards</subject><subject>Network Meta-Analysis</subject><subject>Randomized Controlled Trials as Topic - methods</subject><subject>Reoperation - methods</subject><subject>Reoperation - standards</subject><subject>Success</subject><issn>1533-3159</issn><issn>2150-1149</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkDtPwzAYRS0EoqXwF5AlFpZI_vw2W1UerVRgABaWyE0c5JLEwU5A_fcEURamO9yjq6N7gKYUBMkAuDlEUxCMZQyEmaCTlLaEMGkMO0YTqg3jmvApel2EprPRp9DiUGGFn4b45gtb41Xbu_jp2t6HNuEqRLwemo2N-NqnAi9dbL396a7wHD-4_ivEd3zvepvZ1ta75NMpOqpsndzZPmfo5fbmebHM1o93q8V8nXUgeJ9pwxWUo5ABq4BBwcBQXhFjQEkNxgmQpXKSV0xR6qQtrWYbAtSSQppKsxm6_N3tYvgYXOrzZjR0dW1bF4aUg-FUKqX1D3rxD92GIY6-KadSSAKghRip8z01bBpX5l30jY27_O819g0oxGcp</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Feng, Fan</creator><creator>Xu, Qianqian</creator><creator>Yan, Feifei</creator><creator>Xie, Yuanlong</creator><creator>Deng, Zhouming</creator><creator>Hu, Chao</creator><creator>Zhu, Xiaobin</creator><creator>Cai, Lin</creator><general>American Society of Interventional Pain Physician</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170901</creationdate><title>Comparison of 7 Surgical Interventions for Lumbar Disc Herniation: A Network Meta-analysis</title><author>Feng, Fan ; 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It is important that the safety and efficacy of all new innovative procedures be compared with currently accepted forms of treatment; however, the previous pairwise meta-analyses could not develop the hierarchy of these treatments.
The purpose of the study is to perform a network meta-analysis to evaluate the clinical results of 7 surgical interventions for the treatment of lumbar disc herniation.
Network meta-analysis of randomized controlled trials (RCTs) for multiple treatment comparisons of lumbar disc herniation.
We performed a Bayesian-framework network meta-analysis of RCTs to compare 7 surgical interventions for people with lumbar disc herniation. The eligible RCTs were identified by searching Embase, Pubmed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google scholar. Data from 3 outcomes (success, complications, and reoperation rate) were independently extracted by 2 authors.
A total of 29 RCTs including 3,146 participants were finally included into this article. Our meta-analysis provides hierarchies of these 7 interventions. For the success rate the rank probability (from best to worst): percutaneous endoscopic lumber discectomy (PELD) > standard open discectomy (SOD) > standard open microsurgical discectomy (SOMD) > chemonucleolysis (CN) > microendoscopic discectomy (MED) > percutaneous laser disc decompression (PLDD) > automated percutaneous lumber discectomy (APLD). For the complication rate the rank probability (from best to worst): PELD > SOMD > SOD > MED > PLDD > CN > APLD. For the reoperation rate the rank probability (from best to worst): SOMD > SOD > MED > PLDD > PELD > CN > APLD.
The limitations of this network meta-analysis include the range of study populations and inconformity of the follow-up times and outcome measurements.
This meta-analysis provides evidence that PELD might be the best choice to increase the success rate and decrease the complication rate, moreover SOMD might be the best option to drop the reoperation rate. APLD might lead to the lowest success rate and the highest complication and reoperation rate. Higher quality RCTs and direct head to head trials are needed to confirm these results.Key words: Lumbar disc herniation, discectomy, minimally invasive surgery, network meta-analysis.</abstract><cop>United States</cop><pub>American Society of Interventional Pain Physician</pub><pmid>28934804</pmid><oa>free_for_read</oa></addata></record> |
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| subjects | Decompression, Surgical - methods Decompression, Surgical - standards Diskectomy - methods Diskectomy - standards Diskectomy, Percutaneous - methods Diskectomy, Percutaneous - standards Endoscopy - methods Endoscopy - standards Humans Intervertebral Disc - diagnostic imaging Intervertebral Disc - surgery Intervertebral Disc Degeneration - diagnostic imaging Intervertebral Disc Degeneration - surgery Intervertebral Disc Displacement - diagnostic imaging Intervertebral Disc Displacement - surgery Laser discs Lumbar Vertebrae - diagnostic imaging Lumbar Vertebrae - surgery Meta-analysis Minimally Invasive Surgical Procedures - methods Minimally Invasive Surgical Procedures - standards Network Meta-Analysis Randomized Controlled Trials as Topic - methods Reoperation - methods Reoperation - standards Success |
| title | Comparison of 7 Surgical Interventions for Lumbar Disc Herniation: A Network Meta-analysis |
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