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Scientific Innovation in Asia

Volume 3, 2025 - Issue 1

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Vol. 3 (2025)
Vol. 2 (2024)
Vol. 1 (2023)
Journal Article An open access journal
Open Access Journal Article

Functional Outcome and Recurrent Lumbar Disc Herniation Following Minimally-invasive Surgical Interventions: A Systematic Review and Meta-analysis

by Shaher Bano 1,2 ,  Zejing Zhao ,  Yijian Gao ,  Zhirui Jiang ,  Muhammad Atta Ul Mustafa  and  Bin Ning
1
Cheeloo College of Medicine, Jinan Central Hospital, Shandong University, Jinan, People’s Republic of China.
2
Central Hospital Affiliated to Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China.
*
Author to whom correspondence should be addressed.
SIA  2025 3(1):33; https://doi.org/10.12410/sia0201017
Received: 1 February 2025 / Accepted: 17 February 2025 / Published Online: 19 February 2025
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Abstract

Background: Low back pain (LBP), affecting ~10% of the global population, is a major public health challenge, with elevated prevalence in China (20.88–29.88%). Lumbar disc herniation (LDH), a leading cause of LBP (12–43% of cases), involves nucleus pulposus displacement and annulus fibrosus compromise. While conservative therapies resolve symptoms in 75% of patients, refractory cases necessitate surgery. Percutaneous Endoscopic Lumbar Discectomy (PELD) is a minimally invasive option with favorable outcomes. This systematic review and meta-analysis evaluate the efficacy of minimally invasive surgeries for LDH, focusing on pain reduction, functional improvement, and recurrence.

Methods: Following PRISMA guidelines, PubMed, Scopus, and Web of Science were systematically searched using keywords related to LDH, minimally invasive surgery, and clinical outcomes. Eligible studies included confirmed LDH diagnoses, detailed surgical data, and postoperative outcome measures. Two researchers independently screened articles and extracted data. Meta-analyses (RevMan 5.4, STATA 17.0) employed random-effects models to calculate mean differences (MDs) and odds ratios (ORs). Sensitivity and publication bias analyses were conducted.

Results: Among 11,626 screened articles, 14 studies (1,108 patients) met inclusion criteria. All procedures significantly reduced back and leg pain at 3, 6, and 12 months postoperatively. Unilateral Biportal Endoscopic (UBE) surgery demonstrated the largest improvements in Visual Analog Scale (VAS) scores for back and leg pain across all intervals. PELD with annular suture yielded the highest Oswestry Disability Index (ODI) improvements (MD: 65.32 at 3 months; 70.93 at 12 months). UBE also outperformed other techniques in functional outcomes. Recurrence rates between Microendoscopic Lumbar Discectomy (MELD) and PELD were comparable (OR: 0.90; 95% CI: 0.37–2.22).

Conclusion: Minimally invasive surgeries, particularly UBE and PELD with annular suture, significantly improve pain and function in LDH patients. Despite methodological heterogeneity, results robustly support their efficacy. Personalized surgical selection and standardized protocols are critical to optimizing outcomes. Future research should prioritize identifying patient-specific predictors of success to guide precision interventions. This analysis provides evidence-based insights to enhance clinical decision-making and patient quality of life.

Keywords: Low Back Pain; Visual Analog Scale; Lumbar Disc Herniation; Percutaneous Endoscopic Lumbar Discectomy; Micro-endoscopic Lumbar Discectomy; Unilateral Biportal Endoscopic.;
Copyright: © 2025 by Bano, Zhao, Gao, Jiang, Mustafa and Ning. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (Creative Commons Attribution 4.0 International License). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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ACS Style
Bano, S.; Zhao, Z.; Gao, Y.; Jiang, Z.; Mustafa, M. A. U.; Ning, B. Functional Outcome and Recurrent Lumbar Disc Herniation Following Minimally-invasive Surgical Interventions: A Systematic Review and Meta-analysis. Scientific Innovation in Asia, 2025, 3, 33. doi:10.12410/sia0201017
AMA Style
Bano S, Zhao Z, Gao Y et al.. Functional Outcome and Recurrent Lumbar Disc Herniation Following Minimally-invasive Surgical Interventions: A Systematic Review and Meta-analysis. Scientific Innovation in Asia; 2025, 3(1):33. doi:10.12410/sia0201017
Chicago/Turabian Style
Bano, Shaher; Zhao, Zejing; Gao, Yijian; Jiang, Zhirui; Mustafa, Muhammad A. U.; Ning, Bin 2025. "Functional Outcome and Recurrent Lumbar Disc Herniation Following Minimally-invasive Surgical Interventions: A Systematic Review and Meta-analysis" Scientific Innovation in Asia 3, no.1:33. doi:10.12410/sia0201017

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