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Updated: Jul 19, 2026
Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
Published on: September 8, 2023
Microendoscopic discectomy for lumbar disc herniation: surgical technique and outcome in 873 consecutive cases
Xiaotao Wu1, Suyang Zhuang, Zubin Mao
1Department of Orthopaedic Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, China. wuxiaotao@medmail.com.cn
Study Design:
A retrospective review involving 873 consecutive cases of lumbar disc herniation treated by microendoscopic discectomy (MED) was conducted and a mean 28-month follow-up was performed.
Objective:
The purpose of this study was to describe the MED technique for lumbar disc herniation and report long-time outcome and complications.
Summary Of Background Data:
The conception of MED was introduced in 1997. Long-time outcome has not been described.
Method:
A total of 873 consecutive patients with lumbar disc herniation were treated with the METRx system. Oswestry Disability Index (ODI) was used to quantify pain relief. The degree of pain and disability was also measured by visual analog scale (VAS) and modified MacNab criteria. A control group of 358 patients treated with standard open discectomy was used for comparison.
Results:
There was significant improvement in the mean preoperative and postoperative VAS and ODI score for the MED and open groups, and there was no statistical difference of the pain improvement between the two groups. For the MED group, average length of hospital stay was 4.8 days; mean time to return to work or normal activities was 15 days; average operative blood loss per level was 44 mL. These were significantly less than open group.
Conclusions:
MED is an effective microendoscopic system with fine long-term outcome in treating lumbar disc herniation. The endoscopic approach allows smaller incisions and less tissue trauma, compared with standard open microdiscectomy. Strict adherence to well-defined preoperative selection criteria could ensure optimal postoperative outcome.
Insights
Microendoscopic discectomy (MED) effectively treats lumbar disc herniation with outcomes comparable to open surgery. This minimally invasive technique offers reduced hospital stays and faster recovery, making it a valuable option for patients.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
Background:
- Microendoscopic discectomy (MED) was introduced in 1997.
- Long-term outcomes of MED for lumbar disc herniation have not been extensively described.
Purpose of the Study:
- To describe the microendoscopic discectomy (MED) technique for lumbar disc herniation.
- To report the long-term outcomes and complication rates associated with MED.
Main Methods:
- A retrospective review of 873 patients undergoing MED for lumbar disc herniation.
- Comparison with a control group of 358 patients treated with standard open discectomy.
- Assessment of pain and disability using Oswestry Disability Index (ODI) and Visual Analog Scale (VAS).
Main Results:
- Both MED and open discectomy groups showed significant improvement in VAS and ODI scores.
- No statistical difference in pain improvement between MED and open discectomy.
- MED group experienced significantly shorter hospital stays, faster return to activities, and less blood loss compared to the open group.
Conclusions:
- Microendoscopic discectomy (MED) is an effective treatment for lumbar disc herniation with favorable long-term outcomes.
- The endoscopic approach offers advantages of smaller incisions and reduced tissue trauma.
- Careful patient selection is crucial for optimizing postoperative results with MED.
