Is annular repair technique useful for reducing reherniation and reoperation after limited discectomy

BackgroundThe annular defect because of the primary lumbar disc herniation (LDH) or surgical procedure is considered as a main reason for recurrent herniation and eventually reoperation. Efforts to close the defect with annular repair devices have been attempted several times but the results were controversial. The present aims to detect whether the annular repair techniques were useful for reducing the re-herniation and re-operation rate after limited discectomy for LDH patients.MethodsThe Pubmed, Cochrane library, and Embase databases were searched to retrieve relevant studies published before January 1, 2020. Continuous variables were compared by calculating the standard difference of the means (SDM), whereas categorical dichotomous variables were assessed using relative risks (RRs). A random-effects model was used if the heterogeneity statistic was significant; otherwise, a fixed-effects model was used. ResultsA total of 10 researches were suitable for the meta-analysis, including four different repair techniques and a total of 1907 participates (1203 treated and 704 control). In comparison with the control group, there was no statistical difference with the ODI, VAS-leg, and VAS-back scales for patients treated with annular repair. However, the use of an annular repair device was associated with a significant reduction in the re-herniation (p=0.004) and re-operation (0.004) rates. There was no difference between the groups with the perioperative complications, but much more device related long term complications happened in the annual repair group (p=0.031) though it still decreased the overall re-operation rate significantly (p=0.006).ConclusionOur results demonstrated that the use of an annular repair device was safe and useful for reducing re-herniation and re-operation rates.