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. 2020 Feb 29;14(1):72-78.
doi: 10.14444/7010. eCollection 2020 Feb.

Percutaneous Endoscopic Lumbar Discectomy Versus Microdiscectomy for the Treatment of Lumbar Disc Herniation: Pain, Disability, and Complication Rate-A Randomized Clinical Trial

Guilherme Meyer  1   2 , Ivan Dias DA Rocha  1 , Alexandre Fogaça Cristante  1 , Raphael Martus Marcon  1 , Thiago Pereira Coutinho  1 , Alessandro Gonzalez Torelli  1 , Pedro Araujo Petersen  1 , Olavo Biraghi Letaif  1 , Tarcísio Eloy Pessoa DE Barros Filho  1
Affiliations

Percutaneous Endoscopic Lumbar Discectomy Versus Microdiscectomy for the Treatment of Lumbar Disc Herniation: Pain, Disability, and Complication Rate-A Randomized Clinical Trial

Guilherme Meyer et al. Int J Spine Surg. .

Abstract

Purpose: The objective was to compare the traditional microdiscectomy with percutaneous endoscopic lumbar discectomy for the treatment of disc herniations regarding pain, disability, and complications.

Methods: Randomized clinical trial with 47 patients with disc herniations treated with 2 different surgical techniques: traditional microdiscectomy or percutaneous endoscopic lumbar discectomy. Forty-seven patients were divided into 2 groups and monitored for 12 months. Irradiated and low back pain were evaluated with the visual analog scale. Surgery complications were recorded.

Results: After surgery, the sciatica and disability improved significantly but without significant differences between the groups. Improvements in back pain were significant until the third month. There were no statistical differences between groups regarding recurrence, infection, and the need for reoperation.

Conclusions: Endoscopic discectomy results are similar to those of conventional microdiscectomy regarding pain and disability improvement. Postoperative lumbar pain is less intense with endoscopic discectomy than conventional microdiscectomy only during the first 3 months. Endoscopic discectomy is a safe and efficient alternative to microdiscectomy.

Clinical trials: Trial protocol registration number: RBR-5symrd (http://www.ensaiosclinicos.gov.br).

Keywords: diskectomy; endoscopy; intervertebral disc; intervertebral disc displacement; microsurgery; percutaneous; prospective studies.

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Conflict of interest statement

Disclosures and COI: The authors have no competing interests to declare. There is no funding source. This article was revised and approved by an institutional review board. Informed consent was obtained from all individual participants included in the study.

Figures

Figure 1
Figure 1
Endoscopic view of a right-side L5–S1 foraminal herniation. A: exiting nerve root; B: extruded disc fragment; C: flavum ligament on the dorsal limit of the foramen; D: foraminal fat.
Figure 2
Figure 2
Endoscopic view of the opening of the flavum ligament. A: flavum ligament; B: epidural fat beneath the flavum ligament.
Figure 3
Figure 3
Function as measured by the Oswestry Disability Index (ODI) before and after surgery for herniated disc treatment in patients submitted to microdiscectomy (MD) or endoscopic discectomy (ED). Values are shown as the mean scores in each follow-up point. P > .05 for comparisons between the study groups.
See this image and copyright information in PMC

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