关键词: 腰椎间盘突出症, 髓核摘除, 显微镜, Meta分析

Abstract: Objective To evaluate the therapeutic effect of microscopic and traditional nucleus pulposus discectomy for lumbar disc herniation with Meta- analysis. Methods PubMed，Cochrane Library，SinoMed，CNKI and Wanfang Standards Database were searched. The retrieval date was till Jan. 2017. The results of microscopic discectomy were compared with those of traditional nucleus pulposus discectomy，with randomized controlled trial of lumbar disc herniation. The study strictly evaluated thequality of the methodology incorporated into the study and extracted the data，with software RevMan 5. 3. Results A total of 7 randomized controlled trials were included，2 in foreign language，5 in Chinese，918 in surgery，461 in microscopic group and 457 in the traditional group. According to the improved Jadad score，6 were high quality literatures，1 was low quality literature，and the bias risk assessment was moderate. The Meta analysis showed the incisons of microscopic group were smaller than those of traditional group（ MD = -2. 16，95% CI（-2. 88，-1. 44）， P < 0. 000 01< 0. 05）. Microscopic group had less blood loss than that of traditional group（ MD = -43. 65，95% CI（-52. 19，-35. 11），P < 0. 000 01< 0. 05）. There was no significant difference of operation time between the two groups（ P = 0. 92）. The time of hospitalization in the microscopic group was significantly lower than that in the traditional group（ MD = -2. 52，95% CI（-4. 35，-0. 69）， P = 0. 007 < 0. 05）. There was no significant difference of excellent rate between the two groups（ P = 0. 76 > 0. 05）. There was no significant difference of VAS score between the two groups（ P = 0. 13 > 0. 05）. Conclusion Compared with the traditional nucleus pulposus discectomy，the microscopic discectomy has the advantages of smaller incision，less intraoperative bleeding and shorter hospitalization time. It is worthy of clinical practice. However，there is no significant difference of the operation time，the excellent rate of postoperative improvement and the pain improvement. The surgeon can choose the surgical approach according to their own experience and the actual situation.

Key words: lumbar disc herniation, nucleus pulposus removal, microscopy, Meta-analysis