Dataset Information

Comparison of treatments for lumbar disc herniation: Systematic review with network meta-analysis.

ABSTRACT:

Study design

Systematic review with network meta-analysis.

Objective

To compare patient outcomes of lumbar discectomy with bone-anchored annular closure (LD + AC), lumbar discectomy (LD), and continuing conservative care (CC) for treatment of lumbar disc herniation refractory to initial conservative management.

Summary of background data

Several treatment options are available to patients with refractory symptoms of lumbar disc herniation, but their comparative efficacy is unclear.

Methods

A systematic review was performed to compare efficacy of LD + AC, LD, and CC for treatment of lumbar disc herniation. Outcomes included leg pain, back pain, disability (each reported on a 0-100 scale), reherniation, and reoperation. Data were analyzed using random effects network meta-analysis.

Results

This review included 14 comparative studies (8 randomized) involving 3947 patients-11 studies of LD versus CC (3232 patients), 3 studies of LD + AC versus LD (715 patients), and no studies of LD + AC versus CC. LD was more effective than CC in reducing leg pain (mean difference [MD] -10, P < .001) and back pain (MD -7, P < .001). LD + AC was more effective than LD in reducing risk of reherniation (odds ratio 0.38, P < .001) and reoperation (odds ratio 0.33, P < .001). There was indirect evidence that LD + AC was more effective than CC in reducing leg pain (MD -25, P = .003), back pain (MD -20, P = .02), and disability (MD -13, P = .02) although the treatment effect was smaller in randomized trials.

Conclusions

Results of a network meta-analysis show LD is more effective than CC in alleviating symptoms of lumbar disc herniation refractory to initial conservative management. Further, LD + AC lowers risk of reherniation and reoperation versus LD and may improve patient symptoms more than CC.

SUBMITTER: Arts MP

PROVIDER: S-EPMC6408089 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Comparison of treatments for lumbar disc herniation: Systematic review with network meta-analysis.

Arts Mark P MP Kuršumović Adisa A Miller Larry E LE Wolfs Jasper F C JFC Perrin Jason M JM Van de Kelft Erik E Heidecke Volkmar V

Medicine 20190201 7

<h4>Study design</h4>Systematic review with network meta-analysis.<h4>Objective</h4>To compare patient outcomes of lumbar discectomy with bone-anchored annular closure (LD + AC), lumbar discectomy (LD), and continuing conservative care (CC) for treatment of lumbar disc herniation refractory to initial conservative management.<h4>Summary of background data</h4>Several treatment options are available to patients with refractory symptoms of lumbar disc herniation, but their comparative efficacy is ...[more]

PMID: 30762743

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Dataset Information

Comparison of treatments for lumbar disc herniation: Systematic review with network meta-analysis.

Study design

Objective

Summary of background data

Methods

Results

Conclusions

Publications

Comparison of treatments for lumbar disc herniation: Systematic review with network meta-analysis.

Similar Datasets

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