Trial reportJAMA2009
Tubular diskectomy vs conventional microdiskectomy for sciatica: a randomized controlled trial.
Trial report in JAMA, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 15 of them syntheses that pooled it.
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
77 citing papers in PubMed, 15 syntheses or guidelines pooled it, 235 citations in OpenAlex.
- Comparison of different treatments for lumbar disc herniation: a network meta-analysis and systematic review.BMC surgery · 2025Pooled it
- Comparative efficacy and safety of three surgical procedures for the treatment of lumbar disc herniation: a Bayesian-based network analysis.BMC surgery · 2025Pooled it
- Clinical Evaluation of Surgery for Single-Segment Lumbar Spinal Stenosis: A Systematic Review and Bayesian Network Meta-Analysis.Orthopaedic surgery · 2022Pooled it
- Eight Surgical Interventions for Lumbar Disc Herniation: A Network Meta-Analysis on Complications.Frontiers in surgery · 2021Pooled it
- Pooled it
- Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis.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 · 2015Pooled it
- Incidence of Low Back Pain After Lumbar Discectomy for Herniated Disc and Its Effect on Patient-reported Outcomes.Clinical orthopaedics and related research · 2015Pooled it
- Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis.The Cochrane database of systematic reviews · 2015Pooled it
- Minimally invasive discectomy versus microdiscectomy/open discectomy for symptomatic lumbar disc herniation.The Cochrane database of systematic reviews · 2014Pooled it
- The safety and efficacy of minimally invasive discectomy: a meta-analysis of prospective randomised controlled trials.International orthopaedics · 2014Pooled it
- Minimally invasive surgery for lumbar disc herniation: a systematic review and meta-analysis.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 · 2014Pooled it
- Rehabilitation after lumbar disc surgery.The Cochrane database of systematic reviews · 2014Pooled it
- Systematic review of microendoscopic discectomy for lumbar disc herniation.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 · 2013Pooled it
- Surgical techniques for sciatica due to herniated disc, a systematic review.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 · 2012Pooled it
- The efficacy of minimally invasive discectomy compared with open discectomy: a meta-analysis of prospective randomized controlled trials.Journal of neurosurgery. Spine · 2012Pooled it
- Full endoscopic versus open discectomy for sciatica: randomised controlled non-inferiority trial.BMJ (Clinical research ed.) · 2022Trial
- Trial
- Percutaneous laser disc decompression versus microdiscectomy for sciatica: Cost utility analysis alongside a randomized controlled trial.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2017Trial
- Percutaneous laser disc decompression versus conventional microdiscectomy for patients with sciatica: Two-year results of a randomised controlled trial.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2017Trial
- IPD without bony decompression versus conventional surgical decompression for lumbar spinal stenosis: 2-year results of a double-blind randomized controlled trial.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 · 2015Trial
17 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextConventional microdiskectomy is the most frequently performed surgery for patients with sciatica due to lumbar disk herniation. Transmuscular tubular diskectomy has been introduced to increase the rate of recovery, although evidence is lacking of its efficacy.
objectiveTo determine outcomes and time to recovery in patients treated with tubular diskectomy compared with conventional microdiskectomy. DESIGN, SETTING, AND PATIENTS: The Sciatica Micro-Endoscopic Diskectomy randomized controlled trial was conducted among 328 patients aged 18 to 70 years who had persistent leg pain (>8 weeks) due to lumbar disk herniations at 7 general hospitals in The Netherlands from January 2005 to October 2006. Patients and observers were blinded during the follow-up, which ended 1 year after final enrollment.
interventionsTubular diskectomy (n = 167) vs conventional microdiskectomy (n = 161).
main outcome measuresThe primary outcome was functional assessment on the Roland-Morris Disability Questionnaire (RDQ) for sciatica (score range: 0-23, with higher scores indicating worse functional status) at 8 weeks and 1 year after randomization. Secondary outcomes were scores on the visual analog scale for leg pain and back pain (score range: 0-100 mm) and patient's self-report of recovery (measured on a Likert 7-point scale).
resultsBased on intention-to-treat analysis, the mean RDQ score during the first year after surgery was 6.2 (95% confidence interval [CI], 5.6 to 6.8) for tubular diskectomy and 5.4 (95% CI, 4.6 to 6.2) for conventional microdiskectomy (between-group mean difference, 0.8; 95% CI, -0.2 to 1.7). At 8 weeks after surgery, the RDQ mean (SE) score was 5.8 (0.4) for tubular diskectomy and 4.9 (0.5) for conventional microdiskectomy (between-group mean difference, 0.8; 95% CI, -0.4 to 2.1). At 1 year, the RDQ mean (SE) score was 4.7 (0.5) for tubular diskectomy and 3.4 (0.5) for conventional microdiskectomy (between-group mean difference, 1.3; 95% CI, 0.03 to 2.6) in favor of conventional microdiskectomy. On the visual analog scale, the 1-year between-group mean difference in improvement was 4.2 mm (95% CI, 0.9 to 7.5 mm) for leg pain and 3.5 mm (95% CI, 0.1 to 6.9 mm) for back pain in favor of conventional microdiskectomy. At 1 year, 107 of 156 patients (69%) assigned to tubular diskectomy reported a good recovery vs 120 of 151 patients (79%) assigned to conventional microdiskectomy (odds ratio, 0.59 [95% CI, 0.35 to 0.99]; P = .05).
conclusionsUse of tubular diskectomy compared with conventional microdiskectomy did not result in a statistically significant improvement in the Roland-Morris Disability Questionnaire score. Tubular diskectomy resulted in less favorable results for patient self-reported leg pain, back pain, and recovery.
trial registrationisrctn.org Identifier: ISRCTN51857546.
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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 OpenQuestion graph.