Effectiveness and Safety of Decompression Alone versus Decompression Plus Fusion in Recurrent Lumbar Disc Herniation: A Meta-Analysis Study

Document Type : Meta-analysis

Authors

1 Orthopedic Surgery Department, Faculty of Medicine , Gharian University- Libya

2 Orthopedic Surgery Department, Faculty of Medicine, Zagazig University

Abstract

Background: Recurrent lumbar disc herniation may enhance morbidity during conventional posterior reoperation as complication of post scar formation, making it a serious issue. There is debate on the best surgical method for treating recurrent lumbar disc herniation. The aim of this study is to improve the outcome of patients who do Decompression Alone Versus Decompression Plus Fusion in Recurrent Lumbar Disc Herniation. The primary objective was to study re-operative rates. The secondary objectives included comparing for clinical improvement, operating time, blood loss, complications, and postoperative hospital stays between both techniques Patients and methods: In this Meta-analysis study, we searched the databases of prospective and retrospective studies for the management of RLDH that was confirmed by magnetic resonance Imaging, and we took into account comparative and non-comparative research within the study. The analysis covered both ipsilateral and contralateral disc herniations to study the effectiveness and safety of Decompression Alone versus Decompression Plus Fusion in the management of recurrent lumbar disc herniation (RLDH). The electronic literature search was performed in Google Scholars, Ovid Medline, Cochrane database, and PubMed Medline. Comparative studies and non- comparative studies in humans were selected. Results: the intraoperative and postoperative complications, including dural tear, neurological deficit, instability, surgical site infection, adjacent segment disease (ASD), pseudoarhtrosis, and recurrence and revision rates were comparable with the studied researches. Conclusion: The current study showed that decompression plus fusion procedure was associated with better functional outcome and lower complications compared to decompression only in the treatment of recurrent lumbar disc herniation.

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