Full transforaminal endoscopic discectomy versus microlumbar discectomy for lumbar disc herniation: 2-year results

Abstract

Abstract Objective: Microlumbar discectomy (MLD) has been a gold standard surgical treatment of lumbar disc herniation (LDH); we have compared its results with full transforaminal endoscopic discectomy (FTED), which is a recent trend performed under local anesthesia. FTED and MLD are currently prevalent techniques for the surgical treatment of LDH. Materials and Methods: Patients were randomly assigned to the FTED or MLD groups in this single center study if they had clinical LDH with low back ache with radiculopathy confirmed with magnetic resonance imaging findings. The Oswestry disability index score was the primary outcome. 36-Item Short-Form Health Survey, Macnab, and visual analog scales for back pain and leg pain were used as secondary outcomes. Results: Over a follow-up of 2 years, both primary and secondary outcomes differed significantly according to the location of the discs; FTED was very successful in foraminal and extraforaminal herniated discs with many other benefits whereas MLD was better in central discs. Conclusion: FTED is superior in cosmesis, returning to work in 2 weeks, less surgical trauma, minimal bleeding, infection, hospital stay, and surgical scar compared with MLD. FTED was found to be less effective for median disc herniation, whereas MLD did not appear to be the best alternative for foraminal/extraforaminal disc herniation.