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Updated: May 3, 2026
Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
Full-endoscopic versus microscopic spinal decompression for lumbar disc herniation: a meta-analysis of 20 cohort
Mingjiang Luo1, Shihang Long1,2, Ziliang Zhao3
1Department of Spine Surgery, Lishui Hospital of Wenzhou Medical University, Lishui People's Hospital, Lishui, Zhejiang, China.
Background:
Full-endoscopic spine decompression (FESD) and microscopic spine decompression (MSD) are both surgical approaches commonly used for the treatment of lumbar disc herniation (LDH). However, their comparative efficacy and safety remain a topic of debate. This meta-analysis aimed to evaluate and compare the clinical outcomes and safety profiles of FESD and MSD in the management of LDH.
Methods:
A comprehensive literature search was conducted in the PubMed, Embase, and Cochrane Library databases to identify relevant studies published up to October 16, 2024. Cohort studies comparing FESD and MSD for the treatment of LDH were included. Data on pain scores, functional outcomes, operative time, hospital stay, and complications were extracted and analyzed. Statistical analysis was performed using a random-effects model. Heterogeneity was assessed using the I2 statistic. Subgroup and sensitivity analyses were conducted to explore potential sources of heterogeneity and assess the robustness of the results. Publication bias was evaluated using Begg's test and funnel plots.
Results:
A total of 20 studies involving 2613 patients were included in the meta-analysis. The results demonstrated that, compared with MSD, FESD was associated with a significantly shorter hospital stay (SMD: 1.72, 95 % CI: 2.44 to -1.00) and reduced intraoperative blood loss (SMD: 2.78, 95 % CI: 4.28 to -1.29). At six months postoperatively, FESD showed superior pain relief as measured by the Visual Analog Scale (VAS) score (SMD: 0.43, 95 % CI: 0.68 to -0.17), with statistical significance. No significant difference was observed between the two techniques in terms of Oswestry Disability Index (ODI) scores.
Conclusion:
This meta-analysis suggests that both FESD and MSD are effective surgical options for the treatment of LDH, with comparable overall clinical outcomes. No significant differences were observed between the two techniques regarding short-term postoperative pain relief and complication rates. However, FESD demonstrated significant advantages in reducing intraoperative blood loss and shortening the length of hospital stay, which may contribute to lower hospitalization costs and reduced patient burden.
