A comparative study of conventional microlumbar discectomy and endoscopic lumbar discectomies

Abstract

Background: Low back pain is fairly common in India and lumbar disc herniation is its most common specific cause. In the present study we compared three minimally invasive surgical modalities for treating lumbar disc herniation.Methods: This prospective observational study was conducted on patients who presented to our department with low back pain with radicular symptoms. Twenty-five patients who underwent either microlumbar disectomy (MLD), percutaneous endoscopic transforaminal lumbar discectomy (PELD) or microendoscopic lumbar discectomies (MED) were compared.Results: Of the total sample of 75 cases, it was found that male population was affected more and the degenerative disc process was more prevalent among those over 40 years of age. The MED had the shortest operative time while MLD had the longest mean duration. A comparison of the intraoperative blood loss was negligible in PELD group and 42.80 ml in MED and 63.20 ml in MLD which was strongly significant with a p<0.001. Pain scores were comparable between the patients in the three surgery groups. We observed significantly higher ODI score for patients in MLD group at in the immediate post-operative, 3 months and 6 months post-operative period.Conclusions: MLD is the gold standard for treatment for lumbar disc disease even today due to its familiarity among neurosurgeons; however, reduced tissue destruction and cosmetic demand with equally good results if not better, endoscopy could replace MLD as the first-line treatment for LDH until lesser invasive modality comes to light.