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Updated: Jul 1, 2026
A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
Full-endoscopic versus microscopic lumbar discectomy for lumbar disc herniation: a systematic review and
Jung Hahn Yong1, Eugene Wang1, Brian Zhaojie Chin2
1Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block Level 10, 1E Kent Ridge Road, Singapore 119228, Singapore.
Background Context:
Full-endoscopic lumbar discectomy for disc herniation has gained attention as a minimally invasive technique aimed at reducing approach-related morbidity while achieving similar outcomes to more conventional microscopic discectomy techniques.
Purpose:
To assess the safety and efficacy of full-endoscopic versus microscopic lumbar discectomy for the treatment of lumbar disc herniation.
Study Design:
Systematic review and meta-analysis.
Methods:
A systematic review of randomised and nonrandomised studies comparing full-endoscopic and microscopic lumbar discectomy was conducted in accordance with the PRISMA guidelines. Treatment effects were estimated using pairwise random-effects meta-analysis. Quality assessment was evaluated using the Joanna Briggs Institute Critical Appraisal Tool.
Results:
A total of 28 primary references comprising 4,186 patients were included. Endoscopic decompression was associated with significantly shorter time to return to work (WMD=-22.61 days, 95% CI: -34.15 to -11.08, p<.01), shorter length of hospital stay (WMD=-2.20 days, 95% CI: -3.16 to -1.24, p<.01), lower risk of postoperative infections (RR=0.38, 95% CI: 0.18 to 0.80, p=.95), and lower risk of delayed wound healing, poor wound healing, and wound dehiscence (RR=0.20, 95% CI: 0.04 to 0.91, p=.93). However, endoscopic decompression was also associated with a higher risk of postoperative dysesthesia (RR=2.28, 95% CI: 1.12 to 4.61, p=.56).
Conclusion:
Full-endoscopic and microscopic decompression are safe and effective techniques for treatment of symptomatic lumbar disc herniation. Prospective studies of larger power considering medium to long-term outcomes and rates of iatrogenic instability are warranted to substantiate findings from the present study.
