Efficacy and safety of ultrasound-guided compared to x-ray-guided percutaneous endoscopic lumbar discectomy in China: a systematic review and pooled analysis
Bibliographic record
Abstract
Background: Percutaneous endoscopic lumbar discectomy (PELD) has become the preferred minimally invasive surgical treatment for lumbar disc herniation. This study aims to conduct a systematic literature review and meta-analysis to assess the efficacy and safety of ultrasound-guided PELD compared to x-ray-guided PELD. Methods: A comprehensive literature search was conducted in the PubMed, Cochrane Library, Ovid:MEDLINE, Embase, and China National Knowledge Infrastructure databases up to August 2024. Studies were included if they compared ultrasound- and x-ray-guided PELD in patients with lumbar disc herniation. Risk of bias and quality of evidence were assessed using the Cochrane Collaboration tools and the Newcastle-Ottawa Scale. The meta-analysis was performed using RevMan 5.4. Results: Seven studies were included, for a total of 767 patients (383 who underwent ultrasound-guided PELD and 384 who underwent x-ray-guided PELD). Ultrasound guidance significantly reduced fluoroscopy shots, radiation dose, fluoroscopy time, and working channel establishment time compared to x-ray guidance. Ultrasound guidance also demonstrated higher one-time puncture success rates. No significant differences were found in overall operative time, complications, postoperative pain scores (visual analog scale), or long-term functional outcomes (oxygen desaturation index and satisfaction rates). Conclusions: Ultrasound-guided PELD significantly reduces radiation exposure and improves puncture efficiency compared to x-ray-guided techniques while maintaining equivalent clinical outcomes and complication rates. However, due to study limitations, including small sample sizes and geographical concentration of research, further multicenter randomized controlled trials are necessary to validate these findings across diverse populations and surgical settings.
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) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.028 |
| 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 | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".