Abstract
Radiculopathies are defined as neurological conditions characterized by nerve root dysfunction. Among its main causes is compression due to a herniated disc. The involvement can be the target of surgical approaches whose objectives focus mainly on decompressing the root, through the removal of the herniated disc. The primary surgical technique for lumbar disc herniation is open discectomy or microdiscectomy. However, there are surgical alternatives whose technique involves partial removal of the nucleus pulposus in a minimally invasive manner. The present study is based on a systematic review of the literature, based on a collection of randomized clinical studies, selected due to greater methodological rigor, with a total inclusion of 1293 participants. Comparative analysis of the evidence suggests that non-invasive surgical techniques may not be inferior to microdiscectomies/open discectomies in terms of clinical parameters, mainly in the assessment of pain and orthopedic disability index scores. Despite longer operative times, certain surgical parameters, such as lower estimated blood loss and complication rate, probably tend to be favorable to minimally invasive discectomies. Therefore, future decisions about performing lumbar discectomy should consider, when there are robust indications, patients’ preferences for a given treatment, as well as its social and economic burden.
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