SynthesisMedicine2019
Comparison of treatments for lumbar disc herniation: Systematic review with network meta-analysis.
Synthesis in Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 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
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Effectiveness of medical ozone injections into the intervertebral disc on relieving lumbosacral pain-a systematic review and meta-analysis.Frontiers in pain research (Lausanne, Switzerland) · 2025Pooled it
- Effect of obesity on results of endoscopic versus open lumbar discectomy: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Clinical performance of a bone-anchored annular closure device in older adults.Clinical interventions in aging · 2019Trial
- Comparison Between Interlaminar and Transforaminal Endoscopic Lumbar Discectomy for Sciatic Scoliosis Secondary to Lumbar Disc Herniation: A Retrospective Study With a Minimum 1 Year Follow-Up.Orthopaedic surgery · 2026Article
- Chronic Corticosteroid Use Is Associated with Increased Postoperative Complications Following Lumbar Microdiscectomy.Spine surgery and related research · 2026Article
- Clinical Characteristics, Surgical Management and Outcomes of Sciatic Scoliosis Secondary to Lumbar Disc Herniation: A Systematic Review.Life (Basel, Switzerland) · 2026Review
- Return to work rate and long-term effectiveness of delayed versus early surgery for back pain and sciatica in Russian railways employees: a single-center retrospective study.Asian spine journal · 2026Article
- Poor predictive performance of early outcome models following lumbar disc herniation surgery.Bone & joint open · 2026Article
- ISASS Recommendations and Coverage Criteria for Bone-Anchored Annular Defect Closure Following Lumbar Discectomy: Coverage Indications, Limitations, and/or Medical Necessity-An ISASS 2025 Policy Update on the Use of Bone-Anchored Annular Closure to Prevent Reherniation in High-Risk Lumbar Discectomy Patients.International journal of spine surgery · 2025Article
- A Retrospective Study of Lumbar Disk Herniation: An Analysis of Clinical Cases and Treatment Plans.Journal of clinical medicine · 2025Article
- Pearls and Pitfalls of Revision Unilateral Biportal Endoscopic Lumbar Spine Surgery: A Technical Note.Cureus · 2025Article
- Article
- Review of Recent Treatment Strategies for Lumbar Disc Herniation (LDH) Focusing on Nonsurgical and Regenerative Therapies.Journal of clinical medicine · 2025Review
- Mechanistic and Clinical Evaluation of Lever-Positioning Manipulation in Lumbar Disc Herniation: A Study Protocol for a Randomized Controlled Trial Using Rs-fMRI.Journal of pain research · 2025Article
- Characteristics of Sciatic Scoliotic List in Lumbar Disc Herniation.Global spine journal · 2024Article
- Role of surgery in primary lumbar disk herniation: WFNS spine committee recommendations.World neurosurgery: X · 2024Review
- Bone resorption around the annular closure device during a postoperative follow-up of 8 years.Acta neurochirurgica · 2024Article
- Annulus Fibrosus Repair for Lumbar Disc Herniation: A Meta-Analysis of Clinical Outcomes From Controlled Studies.Global spine journal · 2024Review
- Deep-Learning-Based Radiomics to Predict Surgical Risk Factors for Lumbar Disc Herniation in Young Patients: A Multicenter Study.Journal of multidisciplinary healthcare · 2024Article
- Clinical and radiomics feature-based outcome analysis in lumbar disc herniation surgery.BMC musculoskeletal disorders · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designSystematic review with network meta-analysis.
objectiveTo compare patient outcomes of lumbar discectomy with bone-anchored annular closure (LD + AC), lumbar discectomy (LD), and continuing conservative care (CC) for treatment of lumbar disc herniation refractory to initial conservative management. SUMMARY OF BACKGROUND DATA: Several treatment options are available to patients with refractory symptoms of lumbar disc herniation, but their comparative efficacy is unclear.
methodsA systematic review was performed to compare efficacy of LD + AC, LD, and CC for treatment of lumbar disc herniation. Outcomes included leg pain, back pain, disability (each reported on a 0-100 scale), reherniation, and reoperation. Data were analyzed using random effects network meta-analysis.
resultsThis review included 14 comparative studies (8 randomized) involving 3947 patients-11 studies of LD versus CC (3232 patients), 3 studies of LD + AC versus LD (715 patients), and no studies of LD + AC versus CC. LD was more effective than CC in reducing leg pain (mean difference [MD] -10, P < .001) and back pain (MD -7, P < .001). LD + AC was more effective than LD in reducing risk of reherniation (odds ratio 0.38, P < .001) and reoperation (odds ratio 0.33, P < .001). There was indirect evidence that LD + AC was more effective than CC in reducing leg pain (MD -25, P = .003), back pain (MD -20, P = .02), and disability (MD -13, P = .02) although the treatment effect was smaller in randomized trials.
conclusionsResults of a network meta-analysis show LD is more effective than CC in alleviating symptoms of lumbar disc herniation refractory to initial conservative management. Further, LD + AC lowers risk of reherniation and reoperation versus LD and may improve patient symptoms more than CC.
Indexed as
Identifiers
What OpenQuestion holds
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 OpenQuestion graph.