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Updated: Jul 8, 2026
Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
Published on: September 8, 2023
The efficacy of microendoscopic discectomy in reducing iatrogenic muscle injury
Dong Ah Shin1, Keung Nyun Kim, Hyun Cheol Shin
1Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Object:
The objective of this study was to evaluate the invasiveness of microendoscopic discectomy (MED) in comparison with microscopic discectomy (MD) by measuring serum levels of creatine phosphokinase (CPK)-MM and lactate dehydrogenase (LDH)-5, and by comparing visual analog scale (VAS) scores of postoperative pain.
Methods:
This study included a group of 15 patients who underwent surgery using MED and 15 patients who underwent surgery using MD, both for single-level unilateral herniated nucleus pulposus. The CPK-MM and LDH-5 levels were measured at admission and after 1, 3, and 5 days postoperatively. Pain assessment was recorded using scores raging from 0 to 10 on a subjective VAS at admission and at 1, 3, and 5 days postoperatively.
Results:
The mean CPK-MM levels were lower for the MED group than for the MD group at both 3 (576.1 +/- 286.3 IU/L compared with 968.1 +/- 377.8 IU/L) and 5 days (348.1 +/- 231.0 IU/L compared with 721.7 +/- 463.2) postoperatively (p < 0.05). The mean VAS scores for postoperative back pain were lower in the MED group than in the MD group, both at 1 (3.3 +/- 2.3 compared with 5.8 +/- 1.5) and 5 days (1.9 +/- 1.1 compared with 3.6 +/- 1.1) postoperatively (p < 0.01).
Conclusions:
The MED procedure is less invasive than MD, and causes less muscle damage and less back pain.
Insights
Microendoscopic discectomy (MED) is less invasive than microscopic discectomy (MD). MED results in reduced muscle damage and less postoperative back pain compared to MD.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
Background:
- Minimally invasive spine surgery techniques aim to reduce patient morbidity.
- Microendoscopic discectomy (MED) and microscopic discectomy (MD) are surgical options for herniated nucleus pulposus.
Purpose of the Study:
- To compare the invasiveness of MED versus MD.
- To evaluate postoperative muscle damage and pain following MED and MD.
Main Methods:
- A comparative study involving 15 patients undergoing MED and 15 patients undergoing MD for single-level unilateral herniated nucleus pulposus.
- Serum creatine phosphokinase (CPK)-MM and lactate dehydrogenase (LDH)-5 levels were measured preoperatively and at 1, 3, and 5 days postoperatively.
- Visual analog scale (VAS) pain scores were recorded at the same time points.
Main Results:
- Lower mean CPK-MM levels were observed in the MED group at 3 and 5 days postoperatively (p < 0.05).
- Significantly lower VAS scores for back pain were reported in the MED group at 1 and 5 days postoperatively (p < 0.01).
Conclusions:
- MED is a less invasive surgical approach compared to MD.
- MED leads to less muscle damage and reduced postoperative back pain.