Patient-reported functional outcomes of endoscopic lumbar microdiscectomy: A non-inferiority meta-analysis

Background and Objectives: Lumbar Disc Herniation (LDH) is a condition characterized by the displacement of intervertebral disc material and represents the most common cause of radiculopathy. Conservative treatment for LDH focuses on lifestyle changes and pharmacologic interventions to manage sympto...

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Main Authors: Mireya Rahman, MD, Emma Butler, Justin Choy
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Interdisciplinary Neurosurgery
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214751925000490
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author Mireya Rahman, MD
Emma Butler
Justin Choy
author_facet Mireya Rahman, MD
Emma Butler
Justin Choy
author_sort Mireya Rahman, MD
collection DOAJ
description Background and Objectives: Lumbar Disc Herniation (LDH) is a condition characterized by the displacement of intervertebral disc material and represents the most common cause of radiculopathy. Conservative treatment for LDH focuses on lifestyle changes and pharmacologic interventions to manage symptoms. Surgery for LDH is indicated when conservative treatment fails, particularly in cases of progressive or persistent neurological deficits and debilitating back or leg pain. Currently, open discectomy and microdiscectomy are the most common treatment methods used today for surgical management of LDH. Literature has yet to establish meaningful differences in functional outcome between the two modalities. The objective of this study is to describe the efficacy of endoscopic microdiscectomy compared to open microdiscectomy as measured by patient-reported functionality outcomes. Methods: A literature search was performed using the PubMed and Scopus databases for randomized control trials using the Oswestry Disability Index (ODI) and Visual Analogue Scales (VAS) for leg and back pain for lumbar disc herniation surgery at 12 months post-operative via endoscopic or microscopic approaches. Ten studies were included in the meta-analysis. Results: The estimated coefficients for ODI (−0.201, p = 0.065), as well as VAS back (−0.037, p = 0.615) and VAS leg (−0.022, p = 0.805) indicate no significant relationship between surgical approach and patient-reported functional outcome at 12 months post-operative. Conclusion: Endoscopic microdiscectomy is an alternative to traditional open and microscopic techniques, demonstrating non-inferiority in functionality and pain outcomes for patients with lumbar disc herniation.
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spelling doaj-art-e153ca60e5d64679a25e3f0d1f95541a2025-08-20T03:49:03ZengElsevierInterdisciplinary Neurosurgery2214-75192025-06-014010203710.1016/j.inat.2025.102037Patient-reported functional outcomes of endoscopic lumbar microdiscectomy: A non-inferiority meta-analysisMireya Rahman, MD0Emma Butler1Justin Choy2Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, TX USA; Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA; Corresponding author at: The Anne Burnett Marion School of Medicine at Texas Christian University, 1651 W Rosedale St, Fort Worth, TX 76104, USA.Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, TX USAAnne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, TX USABackground and Objectives: Lumbar Disc Herniation (LDH) is a condition characterized by the displacement of intervertebral disc material and represents the most common cause of radiculopathy. Conservative treatment for LDH focuses on lifestyle changes and pharmacologic interventions to manage symptoms. Surgery for LDH is indicated when conservative treatment fails, particularly in cases of progressive or persistent neurological deficits and debilitating back or leg pain. Currently, open discectomy and microdiscectomy are the most common treatment methods used today for surgical management of LDH. Literature has yet to establish meaningful differences in functional outcome between the two modalities. The objective of this study is to describe the efficacy of endoscopic microdiscectomy compared to open microdiscectomy as measured by patient-reported functionality outcomes. Methods: A literature search was performed using the PubMed and Scopus databases for randomized control trials using the Oswestry Disability Index (ODI) and Visual Analogue Scales (VAS) for leg and back pain for lumbar disc herniation surgery at 12 months post-operative via endoscopic or microscopic approaches. Ten studies were included in the meta-analysis. Results: The estimated coefficients for ODI (−0.201, p = 0.065), as well as VAS back (−0.037, p = 0.615) and VAS leg (−0.022, p = 0.805) indicate no significant relationship between surgical approach and patient-reported functional outcome at 12 months post-operative. Conclusion: Endoscopic microdiscectomy is an alternative to traditional open and microscopic techniques, demonstrating non-inferiority in functionality and pain outcomes for patients with lumbar disc herniation.http://www.sciencedirect.com/science/article/pii/S2214751925000490MicrodiscectomyLumbar disc herniationEndoscopic spine surgeryminimally invasive spine
spellingShingle Mireya Rahman, MD
Emma Butler
Justin Choy
Patient-reported functional outcomes of endoscopic lumbar microdiscectomy: A non-inferiority meta-analysis
Interdisciplinary Neurosurgery
Microdiscectomy
Lumbar disc herniation
Endoscopic spine surgery
minimally invasive spine
title Patient-reported functional outcomes of endoscopic lumbar microdiscectomy: A non-inferiority meta-analysis
title_full Patient-reported functional outcomes of endoscopic lumbar microdiscectomy: A non-inferiority meta-analysis
title_fullStr Patient-reported functional outcomes of endoscopic lumbar microdiscectomy: A non-inferiority meta-analysis
title_full_unstemmed Patient-reported functional outcomes of endoscopic lumbar microdiscectomy: A non-inferiority meta-analysis
title_short Patient-reported functional outcomes of endoscopic lumbar microdiscectomy: A non-inferiority meta-analysis
title_sort patient reported functional outcomes of endoscopic lumbar microdiscectomy a non inferiority meta analysis
topic Microdiscectomy
Lumbar disc herniation
Endoscopic spine surgery
minimally invasive spine
url http://www.sciencedirect.com/science/article/pii/S2214751925000490
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AT emmabutler patientreportedfunctionaloutcomesofendoscopiclumbarmicrodiscectomyanoninferioritymetaanalysis
AT justinchoy patientreportedfunctionaloutcomesofendoscopiclumbarmicrodiscectomyanoninferioritymetaanalysis