Comparative effectiveness of microsurgery and endoscopic surgery in lumbar disc herniation: A systematic review and meta-analysis
Bibliographic record
Abstract
Lumbar disc herniation, a common degenerative disc disease, adversely affects quality of life and often necessitates surgical intervention. Microsurgery and endoscopic surgery have emerged as alternatives to traditional open surgery, offering reduced pain and shorter recovery times. The aim of this study was to compare the outcomes of microsurgery and endoscopic surgery for lumbar disc herniation, evaluating effectiveness, safety, and patient-reported outcomes. A systematic search was conducted across six databases (EBSCOhost, OVID, ScienceDirect, Scopus, PubMed, and Cochrane) using terms related to lumbar disc herniation, spine injury, minimally invasive biportal endoscopic spine surgery, and conventional microscopic discectomy. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS), and a random-effects meta-analysis calculated mean differences (MD) and 95% confidence intervals (CI). Among the 267 studies screened, two studies met the inclusion criteria for a meta-analysis assessing the functional outcomes and safety of microsurgery and endoscopic surgery in patients with spinal disorders. The meta-analysis indicated that patients who received microscopic surgery had no significant difference in terms of operation time (MD: 3.48; 95%CI: -14.74 –21.70; p=0.71; I²=90%), postoperative drainage (MD: 16.28; 95%CI: -2.33–34.89; p=0.09; I²=47%), postoperative length of stay (MD: -1.26; 95%CI: -2.52–0.00; p=0.05; I²=77%), and postoperative C-reactive protein (CRP) levels (MD: -13.49; 95%CI: -36.85–9.87; p=0.26; I²= 97%) compared to those treated with endoscopic surgery. In conclusion, microscopic surgery and endoscopic surgery yield similar outcomes in terms of operation time, postoperative drainage, postoperative length of stay, and postoperative CRP levels. Therefore, the choice of techniques should be guided by patient-specific factors, surgeon expertise, and the facilities available at the healthcare center.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.029 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.022 | 0.044 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".