Microendoscopic Versus Open discectomy for the Treatment of Extruded Lumbar Disc Herniation: A Comparative Cohort Study

Background: Lumbosciatica syndrome affects millions of people worldwide, usually caused by a herniated disc. Most patients with extruded herniated discs are highly symptomatic, and they respond better to surgical treatment. Several studies have tried to compare the efficacy and benefits of microendoscopic discectomy (MED) and open discectomy (OD). Objective: The objective of this study was to compare the results and complications of our MED experience versus standard OD in patients with lumbar disc extrusion. Material and methods: We included patients from 18 to 60 years with radicular pain syndrome and single-level extruded disc herniation between January 2015 and December 2020. We grouped into two prospective cohorts to undergo MED and OD. We assessed pain scores (VAS) and functional outcomes (ODI) and followed them over 12 months. Results: We found a statistically significant difference in VAS score difference and ODI score difference in the first postoperative evaluations, less operative time, less intraoperative bleeding, fewer days of hospital stay, and less time of return to work in favor of the MED group. Conclusion: Although relief of symptoms was faster among patients with the radicular syndrome in the MED group, this study demonstrated that the MED technique did not result in better overall 1-year functional outcomes than OD; however, in young working-age patients, it is essential to return to work as soon as possible. Our results showed a faster return to work in the MED group.