SynthesisNeurosurgical review2025
Comparison of chemonucleolysis and discectomy in the management of lumbar disc herniation: a comprehensive systematic review and meta-analysis.
Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Cost and outcome comparison between intradiscal condoliase injection and surgical treatment for lumbar disc herniation based on real-world data analysis.Scientific reports · 2025Article
- Efficacy of platelet-rich plasma injection with percutaneous endoscopic lumbar discectomy for lumbar disc herniation: a systematic review and meta-analysis.Frontiers in pharmacology · 2025Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Lumbar disc herniation (LDH) represents a significant cause of pain and physical impairment, negatively impacting the quality of life, and burdening healthcare systems. Despite numerous treatment strategies, optimal management remains a subject of debate. This meta-analysis aims to compare the efficacy and economic impact of chemonucleolysis (CN) and discectomy in the management of LDH. An extensive search of Embase, PubMed, and Cochrane databases yielded 391 records. Following strict inclusion and exclusion criteria, twenty-one studies suitable for a comparative analysis between CN and discectomy were included. This selection was based on patient improvement, including pain scores, complications, and differences in cost and surgery time. A total of 2436 patients were included in this study. Among them, 1,121 patients (46%) underwent discectomy, while 1,315 patients (54%) received the CN approach. Our analysis revealed that discectomy had a significantly higher improvement rate compared with chymopapain CN (OR: 0.45; 95%CI 0.23,0.88) and non-chymopapain CN (OR: 0.61; 95%CI 0.38,0.97). A non-significant inclination towards complication rates was observed with chymopapain CN (OR: 1.90; 95%CI 0.68,5.29). Notably, CN was associated with a considerable cost reduction (SMD: 7.11; 95%CI -11.37,-2.85) and a shorter surgical time (MD: -53.54; 95%CI -57.91,-49.17) compared with discectomy. The evidence synthesized in this meta-analysis suggests superior clinical outcomes for discectomy when compared to CN in managing LDH. However, CN demonstrated a notable advantage in terms of cost-efficiency and operative time, marking it as a potentially preferable option in resource-constrained settings. Nonetheless, more randomized clinical trials and prospective studies are necessary to confirm these findings.
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Registered trials
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