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Updated: Aug 15, 2026
Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
Published on: September 8, 2023
Microendoscopic discectomy compared with standard microsurgical discectomy for treatment of uncontained or large
Constantin Schizas1, Elefterios Tsiridis, Joyti Saksena
1Hôpital Orthopédique de la Suisse Romande, University of Lausanne, Lausanne, Switzerland. cschizas@hotmail.com
Objective:
Minimally invasive spinal techniques have been developed for years in an attempt to minimize trauma. However, most endoscopic techniques have been unable to address uncontained or large contained disc herniations. The aim of this prospective study was to compare the results of microendoscopic discectomy (MED) and microsurgical discectomy in the treatment of patients with uncontained or large contained disc herniations.
Methods:
An independent observer reviewed the treatment of 28 patients. The study group included 14 consecutive patients who underwent MED and 14 consecutive patients who underwent microsurgical discectomy for radicular pain secondary to uncontained or large contained disc herniations during the same period. Patients were followed up for an average of 12 months. They were assessed by use of Oswestry disability questionnaire and low back pain outcome score.
Results:
The average outcome score improvement was of clinical significance in both patient groups. No difference in the scores was found between the two groups. Patients in the MED group required less postoperative analgesia during their stay. One patient in the MED group had a dural tear.
Conclusion:
MED is at least as effective as microsurgical discectomy for treatment of uncontained or large contained disc herniations, although the advantages over the open technique are short lived and did not reach significance. Nonetheless, for the surgeon accustomed to endoscopic techniques, MED seems to be a safe procedure.
Insights
Microendoscopic discectomy (MED) is as effective as microsurgical discectomy for large disc herniations. Both techniques offer significant pain relief, with MED showing potential for reduced postoperative analgesia.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Minimally Invasive Procedures
Background:
- Minimally invasive spinal techniques aim to reduce surgical trauma.
- Existing endoscopic methods often struggle with large or uncontained disc herniations.
Purpose of the Study:
- To compare microendoscopic discectomy (MED) with microsurgical discectomy for treating uncontained or large contained disc herniations.
- To evaluate the efficacy and outcomes of these two surgical approaches.
Main Methods:
- Prospective study of 28 patients with radicular pain due to disc herniations.
- 14 patients underwent MED, and 14 underwent microsurgical discectomy.
- Patients were assessed using Oswestry disability and low back pain outcome scores over a 12-month follow-up.
Main Results:
- Both MED and microsurgical discectomy resulted in clinically significant improvements in outcome scores.
- No significant difference in outcome scores was observed between the two groups.
- The MED group required less postoperative pain medication, with one dural tear reported.
Conclusions:
- Microendoscopic discectomy (MED) is a safe and effective alternative to microsurgical discectomy for large disc herniations.
- While advantages over open surgery may be temporary, MED is viable for surgeons experienced with endoscopic techniques.