A systematic review of full endoscopic versus micro-endoscopic or open discectomy for lumbar disc herniation

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Pain Manag


Aim: Endoscopic discectomies provide several advantages over other techniques such as traditional open lumbar discectomy (OLD) including possibly decreased complications, shorter hospital stay and an earlier return to work.

Methods: An electronic database search including MEDLINE/PubMed, EMBASE, Scopus, Cochrane Database of Systematic Reviews and Cochrane Controlled trials (CENTRAL) were reviewed for randomized controlled trials (RCTs) only.

Results: A total of nine RCTs met inclusion criteria. Three showed benefit of endoscopic discectomy over the comparator with regards to pain relief, with the remaining six studies showing no difference in pain relief or function.

Conclusion: Based on review of the nine included studies, we can conclude that endoscopic discectomy is as effective as other surgical techniques, and has additional benefits of lower complication rate and superior perioperative parameters.


This systematic review investigates the use of a common surgical procedure, endoscopic discectomy, for the surgical treatment of lumbar disc herniation. It is a type of minimally invasive spine surgery (MISS) procedure, which has been shown to be not only effective in outcomes, but also optimal for peri-operative parameters, such as post-operative hospital stay, time duration of surgery and blood loss during the procedure. We utilized five search databases to collect data on only randomized controlled studies that investigated endoscopic discectomy compared with another surgical technique. Our results include nine randomized controlled trials, three of which showed improvement in pain scores for endoscopic discectomies. Consequently, in combination with the optimal peri-operative measures, it is concluded that endoscopic discectomy is a reasonable procedure to treat lumbar disc herniation surgically.

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ePub ahead of print