Observational Cohort Study in Full Endoscopic Lumbar Discectomy: Good Patient Outcomes Despite Learning Curve.

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Spinal Surgery

Background:

• Traditional microdiscectomy (MD) is the gold standard for lumbar disc herniation.
• Endoscopic discectomy (ED) is a less invasive alternative requiring surgical expertise.
• Surgeon learning curves can impact patient outcomes in new surgical techniques.

Purpose of the Study:

• Compare patient outcomes between ED and MD for lumbar disc herniation.
• Evaluate the impact of surgeon experience on ED outcomes.
• Assess the safety and efficacy of ED compared to MD.

Main Methods:

• Retrospective cohort study of adult patients with lumbar disc herniation.
• Comparison of endoscopic discectomy (ED) series (n=295) with microdiscectomy (MD) series (n=214).
• Analysis of perioperative data, clinical outcomes, safety, and surgeon learning curve using Cumulative Sum method.

Main Results:

• ED had longer operative times (61.7 min) than MD (51.1 min) but shorter hospital stays (1.4 vs 2.5 nights).
• Both ED and MD significantly improved back and leg pain.
• ED demonstrated lower rates of complications (4.1% vs 14.5%) and reoperations (6.4% vs 8.9%) than MD.
• Surgeon learning curve observed for ED, reducing operative time with experience.

Conclusions:

• Endoscopic lumbar disc surgery yields comparable clinical outcomes to microdiscectomy.
• ED presents advantages of reduced complications and shorter hospital stays.
• ED is a viable alternative to MD for lumbar disc herniation, with outcomes improving with surgical experience.