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Comparative Study
. 2010 Feb;19(2):181-204.
doi: 10.1007/s00586-009-1155-x. Epub 2009 Sep 15.

Transforaminal endoscopic surgery for symptomatic lumbar disc herniations: a systematic review of the literature

Jorm Nellensteijn  1 , Raymond Ostelo, Ronald Bartels, Wilco Peul, Barend van Royen, Maurits van Tulder
Affiliations
Comparative Study

Transforaminal endoscopic surgery for symptomatic lumbar disc herniations: a systematic review of the literature

Jorm Nellensteijn et al. Eur Spine J. 2010 Feb.

Abstract

The study design includes a systematic literature review. The objective of the study was to evaluate the effectiveness of transforaminal endoscopic surgery and to compare this with open microdiscectomy in patients with symptomatic lumbar disc herniations. Transforaminal endoscopic techniques for patients with symptomatic lumbar disc herniations have become increasingly popular. The literature has not yet been systematically reviewed. A comprehensive systematic literature search of the MEDLINE and EMBASE databases was performed up to May 2008. Two reviewers independently checked all retrieved titles and abstracts and relevant full text articles for inclusion criteria. Included articles were assessed for quality and outcomes were extracted by the two reviewers independently. One randomized controlled trial, 7 non-randomized controlled trials and 31 observational studies were identified. Studies were heterogeneous regarding patient selection, indications, operation techniques, follow-up period and outcome measures and the methodological quality of these studies was poor. The eight trials did not find any statistically significant differences in leg pain reduction between the transforaminal endoscopic surgery group (89%) and the open microdiscectomy group (87%); overall improvement (84 vs. 78%), re-operation rate (6.8 vs. 4.7%) and complication rate (1.5 vs. 1%), respectively. In conclusion, current evidence on the effectiveness of transforaminal endoscopic surgery is poor and does not provide valid information to either support or refute using this type of surgery in patients with symptomatic lumbar disc herniations. High-quality randomized controlled trials with sufficiently large sample sizes are directly needed to evaluate if transforaminal endoscopic surgery is more effective than open microdiscectomy.

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Figures

Fig. 1
Fig. 1
Different posterolateral approaches to the lumbar disc. a The intradiscal technique, b the intracanal technique
See this image and copyright information in PMC

References

    1. Abdullah AF, Ditto EW, III, Byrd EB, et al. Extreme-lateral lumbar disc herniations. Clinical syndrome and special problems of diagnosis. J Neurosurg. 1974;41:229–234. doi: 10.3171/jns.1974.41.2.0229. - DOI - PubMed
    1. Abdullah AF, Wolber PG, Warfield JR, et al. Surgical management of extreme lateral lumbar disc herniations: review of 138 cases. Neurosurgery. 1988;22:648–653. doi: 10.1097/00006123-198804000-00005. - DOI - PubMed
    1. Ahn Y, Lee SH, Park WM, et al. Percutaneous endoscopic lumbar discectomy for recurrent disc herniation: surgical technique, outcome, and prognostic factors of 43 consecutive cases. Spine. 2004;29:E326–E332. doi: 10.1097/01.BRS.0000134591.32462.98. - DOI - PubMed
    1. Caspar W. A new surgical procedure for lumbar disk herniation causing less tissue damage through a microsurgical approach. Adv Neurosurg. 1977;4:74–77.
    1. Chiu JC (2004) Evolving transforaminal endoscopic microdecompression for herniated lumbar discs and spinal stenosis. Surg Technol Int 13:276–286 - PubMed

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