Annulus Fibrosus Repair for Lumbar Disc Herniation: A Meta-Analysis of Clinical Outcomes From Controlled Studies

Author:

Wang Yangbin1ORCID,He Xiaoyu1ORCID,Chen Shupeng1ORCID,Weng Yiyong1ORCID,Liu Zhihua1,Pan Qunlong1ORCID,Zhang Rongmou1ORCID,Li Yizhong1,Wang Hanshi1,Lin Shu2ORCID,Yu Haiming1ORCID

Affiliation:

1. Department of Orthopaedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China

2. Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Royal National Orthopaedic Hospital NHS Trust, Quanzhou, Fujian, China; Group of Neuroendocrinology, Garvan Institute of Medical Research, 384 Victoria St, Sydney, Australia

Abstract

Study Design Meta-analysis . Objectives This study aimed to summarize the clinical efficacy and safety of the various annular defect repair methods that have emerged in recent years. Methods A meta-analysis of randomized and non-randomized controlled trials was conducted. Articles from PubMed, Embase, and the Cochrane Library (CENTRAL) on Lumbar disc herniation treatment with annular repair published from inception to April 2, 2022 were included. We summarized the clinical efficacy and safety of annular repair techniques based on a random-effects model meta-analysis. Results 7 randomized controlled studies and 8 observational studies with a total of 2161 participants met the inclusion criteria. The pooled data analysis showed that adding the annular repair technique reduced postoperative recurrence rate, reoperation rate, and loss of intervertebral height compared with lumbar discectomy alone. Subgroup analysis based on different annular repair techniques showed that the Barricaid Annular Closure Device (ACD) was effective in preventing re-protrusion and reducing reoperation rates, while there was no significant difference between the other subgroups. The annulus fibrosus suture (AFS) did not improve the postoperative Oswestry Disability Index (ODI). No statistically significant difference was observed in the incidence of adverse events between the annular repair and control groups. Conclusions Lumbar discectomy combined with ACD can effectively reduce postoperative recurrence and reoperation rates in patients with LDH. AFS alone was less effective in reducing recurrence and reoperation rates and did not improve postoperative pain and function.

Funder

Science and Technology Bureau of Quanzhou

Natural Science Foundation of Fujian Province

Publisher

SAGE Publications

Subject

Neurology (clinical),Orthopedics and Sports Medicine,Surgery

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