Systematic Review

A systematic review of full endoscopic versus micro-endoscopic or open discectomy for lumbar disc herniation

*Author for correspondence:

Department of Anesthesiology, Pain Management & Perioperative Medicine, Henry Ford Health System, Detroit, MI 48202, USA

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Selaiman Noori

Lakeside Spine & Pain, Lake Havasu, AZ 86403, USA

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Frank Schirripa

https://orcid.org/0000-0001-5286-9857

Division of Rehabilitation & Regenerative Medicine, New York-Presbyterian Hospital, Cornell & Columbia Campuses, New York, NY 10021, USA

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Michael Schirripa

Department of Anesthesiology, New York-Presbyterian/Brooklyn Methodist Hospital, Brooklyn, NY 11215, USA

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Sameer Jain

Pain Treatment Centers of America, White Hall, AK 71602, USA

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Talal Aboud

Department of Neurology, University of Tennessee Health Science Center, Memphis, TN 38163, USA

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Neel Mehta

Division of Pain Medicine, Department of Anesthesiology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY 10021, USA

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Eric Elowitz

Department of Neurosurgery, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY 10021, USA

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Markian Pahuta

Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI 48202, USA

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Sukdeb Datta

Datta Endoscopic Back Surgery & Pain Center, Professorial Lecturer, Mount Sinai School of Medicine, Department of Anesthesiology, New York, NY 10029, USA

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Published Online:23 Aug 2021https://doi.org/10.2217/pmt-2021-0037

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Abstract

Aim: Endoscopic discectomies provide several advantages over other techniques such as traditional open lumbar discectomy (OLD) including possibly decreased complications, shorter hospital stay and an earlier return to work. Methods: An electronic database search including MEDLINE/PubMed, EMBASE, Scopus, Cochrane Database of Systematic Reviews and Cochrane Controlled trials (CENTRAL) were reviewed for randomized controlled trials (RCTs) only. Results: A total of nine RCTs met inclusion criteria. Three showed benefit of endoscopic discectomy over the comparator with regards to pain relief, with the remaining six studies showing no difference in pain relief or function. Conclusion: Based on review of the nine included studies, we can conclude that endoscopic discectomy is as effective as other surgical techniques, and has additional benefits of lower complication rate and superior perioperative parameters.

Lay abstract

This systematic review investigates the use of a common surgical procedure, endoscopic discectomy, for the surgical treatment of lumbar disc herniation. It is a type of minimally invasive spine surgery (MISS) procedure, which has been shown to be not only effective in outcomes, but also optimal for peri-operative parameters, such as post-operative hospital stay, time duration of surgery and blood loss during the procedure. We utilized five search databases to collect data on only randomized controlled studies that investigated endoscopic discectomy compared with another surgical technique. Our results include nine randomized controlled trials, three of which showed improvement in pain scores for endoscopic discectomies. Consequently, in combination with the optimal peri-operative measures, it is concluded that endoscopic discectomy is a reasonable procedure to treat lumbar disc herniation surgically.

Keywords:

Papers of special note have been highlighted as: • of interest

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Vol. 12, No. 1

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History

Received 5 May 2021

Accepted 27 July 2021

Published online 23 August 2021

Published in print January 2022

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Financial & competing interests disclosure

R Aiyer is a member of the Pain Management Editorial Board. They were not involved in any editorial decisions related to the publication of this article, and all author details were blinded to the article's peer reviewers as per the journal's double-blind peer review policy. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

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