Introduction
Lumbar disc herniation is one of the main cause of radiculopathy, with significant burdens on patients and health care systems. While microscopic discectomy is still considered the gold standard in the surgical management of such conditions, endoscopic techniques have recently emerged as a minimally invasive alternative. The present study compares the clinical, surgical, and social outcomes between full-endoscopic and microscopic lumbar discectomy.
Methods
A retrospective study was performed with 53 patients treated at Hôpital du Valais, Switzerland between 2018 and 2022, divided into two groups (endoscopic vs microscopic approach). Outcomes included postoperative pain (VAS, visual analog scale), return-to-activity timelines, post-surgery pain killers needs, length of hospitalization and material. Univariate and multivariable statistical analyses were done to explore the interaction of the surgical technique with various patient-specific factors.
Results
The results showed that endoscopic surgery had shorter operative times (66.22 minutes vs 111.88 minutes) and faster recoveries compared to microscopic surgery (2.93 days vs 4.69 days) without a significant increase in complications (3 vs 4). Multivariable analysis confirmed surgical technique, preoperative pain management, and patient demographics to be the most important predictors for outcome.
Conclusion
Full-endoscopic lumbar discectomy is a safe, effective, and efficient alternative to traditional microscopic techniques. These findings also show the great potential of the endoscopic techniques in improving patient care while optimizing surgical efficiency. However, further research with larger cohorts and longer follow-up periods is needed to validate these findings and explore their long-term implications.