SynthesisBMC surgery2025
Comparison of different treatments for lumbar disc herniation: a network meta-analysis and systematic review.
Synthesis in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed.
- Percutaneous Endoscopic Interlaminar Discectomy via a Modified Inferolateral Margin of the L5 Pedicle Projection for L5/S1 Central Disc Herniation: A Retrospective Study.Journal of clinical medicine · 2026Article
- Artificial Intelligence for Procedural Guidance of Spinal Epidural Steroid Injections: A Scoping Review.Cureus · 2026Review
- Development and internal validation of a nomogram for predicting short-term functional improvement after pharmacological treatment in severe symptomatic lumbar disk herniation.Frontiers in medicine · 2026Article
- The Biomechanical Landscape of Lumbar Disc Herniation: Mechanobiological Insights Into Injury and Regeneration.Neurospine · 2026Review
- Intraspinal versus Extraspinal Acupotomy Decompression, or Their Combination, for Lumbar Disc Herniation: Protocol for a Three-Arm, Randomized, Single-Blind Controlled Trial.Journal of pain research · 2026Article
- A Comparative Analysis of Ultrasound versus Fluoroscopy-Guided Transforaminal Endoscopic Lumbar Discectomy: Protocol for a Randomized Clinical Trial Targeting Lumbar Disc Herniation.Journal of pain research · 2026Article
- Comparison of clinical efficacy and psychological outcomes of femoral neck system combined with rhBMP-2 for young adult femoral neck fractures.Frontiers in surgery · 2026Article
- Impact of transforaminal epidural steroid injection on pain, disability, and kinesiophobia in lumbar disc herniation with radicular pain.Turkish journal of medical sciences · 2026Article
- Letter to the Editor concerning "Comparison of saline consumption between microdiscectomy, uniportal, and biportal endoscopic lumbar disc surgery: a multicenter observational study" by Castel X, et al. (Eur Spine J [2025]: doi:10.1007/s00586-025-09256-3).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundLumbar disc herniation (LDH) is a prevalent spinal disorder that imposes substantial health burdens in the form of chronic pain and mobility limitations, particularly in working-age populations. Due to advancements in technology and materials, the treatments for LDH are constantly being updated. PURPOSE: The purpose of this systematic review and network meta-analysis (NMA) was to compare the outcomes of different LDH treatments. STUDY
designA NMA of randomized controlled trials (RCTs) comparing various treatments for LDH.
methodsThis review was conducted in accordance with to the PRISMA-P guidelines. The PubMed, Embase, Medline, and Cochrane Library electronic databases were systematically searched from 2007 to March 2024 to identify RCTs comparing various treatments for LDH. The outcomes of interest included changes in the pain score, disability score and recurrence rate at the one-year follow-up. The risk of bias among the included studies was assessed using the Cochrane method. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was tailored for network meta-analysis and used to evaluate the overall certainty of the evidence regarding each outcome. This study employed a frequentist approach to conduct the NMA, and all procedures were carried out using the network package in Stata 14.2. The PROSPERO number was CRD42024578677.
resultsTwenty-seven RCTs involving 4633 participants and seven treatment strategies were included. Compared with conservative treatments, all surgical interventions demonstrated better efficacy in pain relief and disability recovery. Among the surgical options, endoscopic discectomy with internal fixation (EDF), percutaneous endoscopic discectomy (PED), microdiscectomy (MD) and open discectomy (OD) were found to be significantly superior to conservative treatments, with EDF showing the best performance. Surface under the cumulative ranking curve (SUCRA) plots displayed the same trend as the NMA results. No significant differences were observed in terms of recurrence rates. However, the SUCRA plots indicated that EDF ranked best in terms of recurrence rates. The GRADE assessment revealed that the quality of most of the evidence was low or very low.
conclusionThe implantation of internal fixation devices was shown to have no impact on quality of life. EDF appears highly effective, especially for pain relief, but other less invasive options, such as PED, have similarly good outcomes in many respects.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.