Comparison of Discectomy versus Sequestrectomy in XXXX : A Meta-Analysis of Comparative Studies.

@entity1 @entity1643 @entity227 @entity190 @entity890
BACKGROUND: Lumbar disc removal is currently the standard treatment for @entity890 . No consensus has been achieved whether aggressive disc resection with curettage (discectomy) versus conservative removal of the offending disc fragment alone (sequestrectomy) provides better outcomes. This study aims to compare the reherniation rate and clinical outcomes between discectomy and sequestrectomy by literature review and a meta-analysis. METHODS: A systematic search of PubMed, Medline, Embase and the Cochrane Library was performed up to June 1, 2014. Outcomes of interest assessing the two techniques included demographic and clinical baseline characteristics, perioperative variables, complications, recurrent herniation rate and post-operative functional outcomes. RESULTS: Twelve eligible trials evaluating discectomy vs sequestrectomy were identified including one randomized controlled study, five prospective and six retrospective comparative studies. By contrast to discectomy, sequestrectomy was associated with significantly less operative time (p<0.001), lower @entity227 ( @entity227 ) for @entity1643 (p<0.05), less post-operative analgesic usage (p<0.05) and better @entity1 ' satisfaction (p<0.05). Recurrent herniation rate, reoperation rate, intraoperative @entity190 , hospitalization duration and @entity227 for sciatica were without significant difference. CONCLUSIONS: According to our pooled data, sequestrectomy entails equivalent reherniation rate and complications compared with discectomy but maintains a lower incidence of recurrent @entity1643 and higher satisfactory rate. High-quality prospective randomized controlled trials are needed to firmly assess these two procedures.
