Microscopic versus endoscopic discectomy: a review
Since the advent of minimally invasive techniques, endoscopic spinal surgery has shown significant promise. Ramsey Chammaa and Bob Chatterjee discuss whether endoscopic discectomy can produce results comparable with open surgery.
Conventional open decompression laminotomy via a posterior approach remains the gold standard approach for symptomatic disc herniation that is resistant to conservative measures; however, micro-discectomy has advantages due to a smaller incision, less tissue trauma, and a shorter operative time and hospital stay (on account of greater magnification of the operative field).
Current literature estimates recurrence rates to be between 3 and 13 per cent, although this does not take into account the length of follow-up and its subsequent effect. Survival analysis has been shown to give a more accurate estimation of the true rate of recurrence: 5 per cent at five years and 7.9 per cent at ten years .
Long-term studies show that patient satisfaction remains high at ten years after micro-discectomy, as evidenced by long-term McNab and Roland-Morris scores demonstrating success rate of 83 per cent at ten years .
Many new techniques have come and gone, but open and micro-discectomy have stood the test of time and remain the standards against which all others are measured; however, since the advent of minimally invasive techniques, endoscopic spinal surgery has…
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