Effect of Lumbar Discectomy or Lumbar Decompression on Axial Back Pain: Results of a Meta-Analysis

This meta-analysis evaluated the impact of lumbar disk herniation and lumbar spinal stenosis (LSS) on axial back pain and the extent of improvement of axial and radicular pain following lumbar decompression and discectomy surgery in patients with low back pain (LBP). A systematic search for published literature between January 2012 and January 2023 was made on PubMed, Google Scholar, and Cochrane library database on 31st January 2023. Original articles that included patients with lumbar disc herniation or LSS who underwent lumbar discectomy or lumbar decompression respectively were included in the study. A total of 71 studies including 16,770 patients with LBP undergoing lumbar discectomy or decompression surgery were included in the meta-analysis. The pooled standard mean difference between postoperative and preoperative: Visual Analog Scale scores for leg pain was −5.14 with 95% confidence interval (CI): −6.59 to −3.69 (P-value = 0) and for back pain was −2.90 with 95% CI: −3.79 to −2.01 (P value = 0), Numerical pain Rating Scale for leg pain was −1.64 with 95% CI: −1.97 to −1.30 (P-value<0.01) and for back pain was −1.58 with 95% CI: −1.84 to −1.32 (P-value <0.01), Oswerty Disability Index score was −4.76 with 95% CI: −6.22 to −3.29 (P-value = 0) and the Japanese Orthopaedic Association score was 3.45 with 95% CI: 0.02 to 6.88 (P value 0) at follow-up. This meta-analysis provides evidence that lumbar discectomy and decompression are effective in improving axial LBP in patients with lumbar disk herniation and LSS.