Related Experiment Video
Updated: Jun 24, 2026
A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
Results of microendoscopic discectomy performed in the 26 cases with a minimum 3 years follow-up
Shih-Sheng Chang1, Tsai-Sheng Fu, Yen-Chiu Liang
1Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Background:
Microendoscopic discectomy (MED) is less invasive than conventional open discectomy, but the long-term benefits of this technique are still debated. Controversy also remains regarding the surgical indications, patient selection, effectiveness, learning curve and complications.
Methods:
From Dec 2001 to Dec 2003, 26 patients with lumbar herniated disc disease received MED. The surgical indications included the following: (1) unilateral, single level lumbar disc herniation; (2) signs and symptoms compatible with the involved nerve root; (3) failure of conservative treatment. These cases were the initial MEDs performed by one of our senior authors (TS FU). Clinical symptoms and outcomes were assessed using the Japanese Orthopaedic Association Back Scores.
Results:
Treatment in two cases was changed to open discectomy because of irreparable dural tears during surgery. For the remaining 24 cases, the average intraoperative blood loss was 55.8 mL. The average operation length was 136.8 minutes and the average post-surgical hospital stay was 2.4 days. At 12 weeks after the operation, 22 achieved excellent or good results. The satisfactory rate was 91.7%. On final follow-up, 21 patients had excellent or good results. The satisfactory rate was 87.5%. Complications included two irreparable dural tears, two superficial wound infections and one pseudomenigocele.
Conclusions:
Our data indicate that MED is an effective procedure for lumbar disc herniation. The result is satisfactory under adequate surgical indications and patient selection. Despite the low complication rate, dural tears still remain a concern during the learning stage.
Insights
Microendoscopic discectomy (MED) offers satisfactory outcomes for lumbar disc herniation when indications and patient selection are appropriate. While complications are infrequent, dural tears pose a risk during the initial learning phase of this minimally invasive technique.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Minimally Invasive Spine Procedures
Background:
- Microendoscopic discectomy (MED) is a less invasive alternative to open discectomy for lumbar disc herniation.
- Long-term benefits, surgical indications, patient selection, effectiveness, learning curve, and complications of MED remain subjects of debate.
- Evaluating the efficacy and safety of MED is crucial for its clinical adoption.
Purpose of the Study:
- To assess the effectiveness and outcomes of microendoscopic discectomy (MED) for lumbar herniated disc disease.
- To evaluate the complication rates associated with MED during the initial learning phase.
- To determine the long-term satisfactory results of MED in a cohort of patients.
Main Methods:
- A prospective study involving 26 patients with lumbar herniated disc disease undergoing MED between December 2001 and December 2003.
- Surgical indications included unilateral, single-level lumbar disc herniation with radicular symptoms and failure of conservative treatment.
- Clinical outcomes were assessed using the Japanese Orthopaedic Association Back Scores.
Main Results:
- Of 26 patients, 24 underwent MED, with 2 requiring conversion to open discectomy due to dural tears.
- The average operation time was 136.8 minutes, with an average blood loss of 55.8 mL and a hospital stay of 2.4 days.
- At 12 weeks, 91.7% had excellent or good results; at final follow-up, 87.5% achieved excellent or good outcomes. Complications included dural tears, wound infections, and pseudomeningocele.
Conclusions:
- Microendoscopic discectomy (MED) is an effective procedure for treating lumbar disc herniation when appropriate surgical indications and patient selection criteria are met.
- The satisfactory outcome rate for MED is high, indicating its clinical utility.
- Dural tears are a significant concern during the learning stage of MED, necessitating careful surgical technique and patient selection.