Percutaneous endoscopic lumbar discectomy versus conventional discectomy for lumbar disc herniation

Background: Controversy continues in regarding with the treatment options for lumbar disc herniation (LDH), including conventional discectomy (CD) and percutaneous endoscopic lumbar discectomy (PELD). The present meta-analysis aims to compare the efficacy and safety of CD and PELD in the surgical treatment of LDH. Methods: The Cochrane Register of Controlled Trials, PubMed, and EMBASE databases were searched for studies comparing PELD and CD in treating LDH. Statistical analysis was conducted using the software Review Manager. The relative risk was calculated for dichotomous outcomes, the mean differences were used for continuous outcomes, and the standardized mean differences for data from disparate outcome measures. Results: Five trials with a total of 392 patients were included in this study. PELD afforded a significantly better rate of patient satisfaction than CD (RR: 0.91; P = 0.85). However, there was no difference between the two procedures in terms of the pain in the lower back and buttocks (P = 0.64), relief of radiculopathy (P = 0.77), relief of abnormal reflexes (P = 0.38), relief of sensory deficit (P = 0. 20), relief of motor weakness (P = 0.63), rate of dura injury (P = 0.97), impaired wound healing (P = 0.87), frequency of urinary retention (P = 0.88), rates of transient dysesthesia (P = 0.69), recurrence rates (P = 0.85), and reoperation rates (P = 0.75). Conclusion: Therefore, we concluded that the currently popular PELD is as safe and efficient as CD in the management of LDH, while also providing better patient satisfaction than CD.