Abstract：
BACKGROUND: Calcified lumbar disc herniation (CLDH) is a subtype characterized by calcification, leading to increased surgical complexity. Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive technique, but its effectiveness and complications in CLDH patients remain to be fully evaluated.
OBJECTIVE: To assess the effectiveness and complications of PELD in treating CLDH patients.
METHODS: A retrospective cohort study combined with a systematic review and meta-analysis.
METHODS: Department of Pain Medicine, an affiliated hospital of a university.
METHODS: Data from patients who underwent PELD in our department between March 2020 and May 2021 were collected. Forty CLDH patients were included in the study group, and equally matched cases with uncalcified lumbar disc herniation (UCLDH) served as controls. A systematic search was conducted on October 5, 2022, using EMBASE, PubMed, Cochrane Library, the China Biology Medicine disk, the China National Knowledge Infrastructure, and the Wanfang databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A random-effects model was used to calculate pooled results.
RESULTS: Eighty patients were included in the retrospective cohort, and 41 studies were included in the meta-analysis. Both the retrospective cohort and meta-analysis consistently showed a significant decrease in visual analog scale (VAS) and Oswestry Disability Index (ODI) scores in the CLDH group after the operation. In the retrospective cohort, the excellent or good rate according to the MacNab classification was 85%, with no reported complications. The meta-analysis revealed a pooled excellent or good rate of 91.8% and a low complication rate of 2.9%. Combining the findings from our retrospective cohort and meta-analysis, we observed that the CLDH group had longer operation times and slightly higher postoperative ODI scores compared to the UCLDH group.
CONCLUSIONS: Small sample size and lack of long-term follow-up in the retrospective cohort, as well as limited inclusion of comparative studies in the meta-analysis.
CONCLUSIONS: PELD is an effective and safe treatment option for CLDH patients. In comparison to UCLDH patients, CLDH patients may experience longer operation times and slightly slower functional recovery than those with UCLDH.
OBJECTIVE: To assess the effectiveness and complications of PELD in treating CLDH patients.
METHODS: A retrospective cohort study combined with a systematic review and meta-analysis.
METHODS: Department of Pain Medicine, an affiliated hospital of a university.
METHODS: Data from patients who underwent PELD in our department between March 2020 and May 2021 were collected. Forty CLDH patients were included in the study group, and equally matched cases with uncalcified lumbar disc herniation (UCLDH) served as controls. A systematic search was conducted on October 5, 2022, using EMBASE, PubMed, Cochrane Library, the China Biology Medicine disk, the China National Knowledge Infrastructure, and the Wanfang databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A random-effects model was used to calculate pooled results.
RESULTS: Eighty patients were included in the retrospective cohort, and 41 studies were included in the meta-analysis. Both the retrospective cohort and meta-analysis consistently showed a significant decrease in visual analog scale (VAS) and Oswestry Disability Index (ODI) scores in the CLDH group after the operation. In the retrospective cohort, the excellent or good rate according to the MacNab classification was 85%, with no reported complications. The meta-analysis revealed a pooled excellent or good rate of 91.8% and a low complication rate of 2.9%. Combining the findings from our retrospective cohort and meta-analysis, we observed that the CLDH group had longer operation times and slightly higher postoperative ODI scores compared to the UCLDH group.
CONCLUSIONS: Small sample size and lack of long-term follow-up in the retrospective cohort, as well as limited inclusion of comparative studies in the meta-analysis.
CONCLUSIONS: PELD is an effective and safe treatment option for CLDH patients. In comparison to UCLDH patients, CLDH patients may experience longer operation times and slightly slower functional recovery than those with UCLDH.
摘要：
背景：钙化型腰椎间盘突出症（CLDH）是一种以钙化为特征的亚型，导致手术复杂性增加。经皮内镜下腰椎间盘切除术(PELD)是一种微创技术,但其在CLDH患者中的有效性和并发症仍有待全面评估。
目的：评估PELD治疗CLDH患者的有效性和并发症。
方法：回顾性队列研究结合系统评价和荟萃分析。
方法：疼痛医学系，一所大学的附属医院。
方法：收集了2020年3月至2021年5月在我们部门接受PELD的患者的数据。将40例CLDH患者纳入研究组，与无钙化腰椎间盘突出症（UCLDH）的病例相同。2022年10月5日，使用EMBASE进行了系统搜索，PubMed,科克伦图书馆,中国生物医药盘，中国国家知识基础设施，和万方数据库，遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目。使用随机效应模型来计算合并结果。
结果：80例患者纳入回顾性队列，41项研究纳入荟萃分析.回顾性队列和荟萃分析均一致显示，CLDH组术后视觉模拟量表（VAS）和Oswestry残疾指数（ODI）评分显着降低。在回顾性队列中，根据MacNab分类，优良率为85%，没有报告的并发症。荟萃分析显示，合并的优良率为91.8％，并发症发生率低，为2.9％。结合我们的回顾性队列和荟萃分析的结果，我们观察到,与UCLDH组相比,CLDH组手术时间更长,术后ODI评分稍高.
结论：回顾性队列中样本量小，缺乏长期随访，以及在荟萃分析中有限地纳入比较研究。
结论：PELD对CLDH患者是一种有效且安全的治疗选择。与UCLDH患者相比，与UCLDH患者相比，CLDH患者可能会经历更长的手术时间和稍慢的功能恢复。
目的：评估PELD治疗CLDH患者的有效性和并发症。
方法：回顾性队列研究结合系统评价和荟萃分析。
方法：疼痛医学系，一所大学的附属医院。
方法：收集了2020年3月至2021年5月在我们部门接受PELD的患者的数据。将40例CLDH患者纳入研究组，与无钙化腰椎间盘突出症（UCLDH）的病例相同。2022年10月5日，使用EMBASE进行了系统搜索，PubMed,科克伦图书馆,中国生物医药盘，中国国家知识基础设施，和万方数据库，遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目。使用随机效应模型来计算合并结果。
结果：80例患者纳入回顾性队列，41项研究纳入荟萃分析.回顾性队列和荟萃分析均一致显示，CLDH组术后视觉模拟量表（VAS）和Oswestry残疾指数（ODI）评分显着降低。在回顾性队列中，根据MacNab分类，优良率为85%，没有报告的并发症。荟萃分析显示，合并的优良率为91.8％，并发症发生率低，为2.9％。结合我们的回顾性队列和荟萃分析的结果，我们观察到,与UCLDH组相比,CLDH组手术时间更长,术后ODI评分稍高.
结论：回顾性队列中样本量小，缺乏长期随访，以及在荟萃分析中有限地纳入比较研究。
结论：PELD对CLDH患者是一种有效且安全的治疗选择。与UCLDH患者相比，与UCLDH患者相比，CLDH患者可能会经历更长的手术时间和稍慢的功能恢复。
