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?

SUBMITTER: Arts MP 

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

REPOSITORIES: biostudies-literature