SYSTEMATIC REVIEW article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1572977
This article is part of the Research TopicMinimally Invasive Treatments for Lumbar Spine DisordersView all 14 articles
Efficacy and safety of ultrasound-guided percutaneous endoscopic lumbar discectomy compared to X-ray-guided in China: A systematic review and Pooled-analysis
Provisionally accepted
- Peking University People's Hospital, Beijing, China
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AbstractBackground: 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 is conducted in PubMed, Cochrane Library, OVID, Embase, and China National Knowledge Infrastructure database up to August 2024. Studies are included if they compared ultrasound and X-ray-guided PELD in patients with lumbar disc herniation. Risk of bias and quality of evidence are assessed using Cochrane Collaboration tools and the Newcastle–Ottawa Scale. Meta-analysis is performed using RevMan 5.4.Results: Seven studies are included, with a total of 767 patients (383 ultrasound-guided PELD, 384 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 also demonstrated higher one-time puncture success rates. No significant differences are found in overall operative time, complications, postoperative pain scores (VAS), or long-term functional outcomes (ODI 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, study limitations including small sample sizes and geographical concentration of research necessitate further multicenter randomized controlled trials to validate these findings across diverse populations and surgical settings.
Keywords: Keyword：Ultrasound, x-ray, Radiation, Percutaneous endoscopic lumbar discectomy, Meta
Received: 08 Feb 2025; Accepted: 05 May 2025.
Copyright: © 2025 Zheng, Yu, Liang, Zhu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). 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.
* Correspondence: Haiying Liu, Peking University People's Hospital, Beijing, China
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