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7. 김다현 김영문 김인겸 이동렬 이준원 임창진 정상훈 책임교수 엄상화. Comparison between MD and MED in VAS, MacNab and complications: Meta-analysis. 7. 김다현 김영문 김인겸 이동렬 이준원 임창진 정상훈 책임교수 엄상화. Comparison between MD and MED in VAS, MacNab and complications: Meta-analysis. 80 %.
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7 김다현 김영문 김인겸 이동렬 이준원 임창진 정상훈 책임교수 엄상화
Comparison between MD and MED in VAS, MacNab and complications: Meta-analysis
7 김다현 김영문 김인겸 이동렬 이준원 임창진 정상훈 책임교수 엄상화
Comparison between MD and MED in VAS, MacNab and complications: Meta-analysis
80% Life-time prevalence of back pain * Adam and Victor’s Principles of Neurology, McGrew-hill, 2009
Herniated intervertebral disc Most common in lumbar lesion
Lumbar Discectomy • No response to conservative Tx. for 6wks • Early, progressive neurologic symptom • Microsugicaldiscectomy (MD)Microendoscopicdiscectomy (MED)
MD vs MED MD MED Less bleeding Fast tissue recovery Short hospital stay Less Postop. pain • Standard • Short op. time • Wide indication (?)
Weakness Process Hypothesis Strategy Collection Coding Analysis Conclusion • Qualitative research • Uneven article quality • Publication bias
Search strategy • JAMA & Archives • PubMed • MEDLINE • EMBASE • Ovid • English • January, 2000~ September, 2010
Quality assessment • Type of studies • Prospective, clinical trial • Retrospective + cohort • Retrospective • Journal grade? • JAMA, NEJM, Lancet • SCI • Domestic, etc • : 1 point • : 0.8 point • : 0.6 point • : 1 point • : 0.8 point • : 0.6 point
Data analysis? (분석방법) • Tools • Excel 2007, RASW statistics 18, MedCalc • Mean-difference 평균차검정? • VAS • 교차분석? • MacNab • Complications
8 VAS 8 MacNab 10 Complications
8 VAS 8 From To MacNab 14 82 10 Cx.
MacNab p-value = 0.001
Complications p-value = 0.962 OR(MED/MD) = 1.010 (95% CI 0.67 – 1.51)
VAS MacNab Cx. I don’t know No difference No difference
Limited language • Changed diagnostic criteria • Uneven article quality • Publications bias • Limited patient indication?
회식은 구제역으로 어려움에 처한 축산농가를 살리기 위해서 돼지고기가 좋겠다는게 개인적인 의견이라능…