Publication: A comparison between repeat discectomy versus fusion for the treatment of recurrent lumbar disc herniation: Systematic review and meta-analysis
Issued Date
2019-08-01
Resource Type
ISSN
15322653
09675868
09675868
Other identifier(s)
2-s2.0-85066110560
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Clinical Neuroscience. Vol.66, (2019), 202-208
Suggested Citation
Chotetawan Tanavalee, Worawat Limthongkul, Wicharn Yingsakmongkol, Panya Luksanapruksa, Weerasak Singhatanadgige A comparison between repeat discectomy versus fusion for the treatment of recurrent lumbar disc herniation: Systematic review and meta-analysis. Journal of Clinical Neuroscience. Vol.66, (2019), 202-208. doi:10.1016/j.jocn.2019.05.004 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51510
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Title
A comparison between repeat discectomy versus fusion for the treatment of recurrent lumbar disc herniation: Systematic review and meta-analysis
Abstract
© 2019 Elsevier Ltd Recurrent lumbar disc herniation is a common negative sequela of primary discectomy. Repeat discectomy versus spinal fusion is constantly debated, and successful outcomes from both treatments remain unclear. Several meta-analysis studies have not reported re-operative rates between the two treatment methods; therefore, we seek to report these outcomes in the following systematic review and meta-analysis design study. The primary objective was to compare re-operative rates between repeat discectomy and fusion treatment. The secondary objectives included comparing clinical improvement, operative time, blood loss, complications, and postoperative hospital stay between repeat discectomy and fusion treatment. The data were gathered from the following sources: PubMed Medline, Ovid Medline, Cochrane database, and Google Scholars. Only comparative studies in humans were selected. There were initially 182 citations found. After the analysis, we found four studies that were compatible with our inclusion criteria. The meta-analysis showed that the re-operative rate seemed to be higher in the discectomy group (9.09%) compared with the fusion group (2.00%), but the difference was not statistically significant. The primary cause of re-operation in the discectomy group is recurrent disc herniation. Two causes of re-operation in the fusion group are adjacent segmental degeneration and implant removal. Operative time and postoperative stay were significantly less in the discectomy group. The improvement rate was not different between the two groups. In conclusion, no difference in re-operation rates between the two surgical treatments was found based on the results of our study. Both treatment techniques have equal improvement rates and complications.