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BioMed Research International
Volume 2015, Article ID 417801, 14 pages
http://dx.doi.org/10.1155/2015/417801
Review Article

Lumbar Endoscopic Microdiscectomy: Where Are We Now? An Updated Literature Review Focused on Clinical Outcome, Complications, and Rate of Recurrence

1Department of Neuroscience, Neurosurgery, Imperial College of London, Charing Cross Hospital, London, UK
2Department of Neurology and Psychiatry, Neurosurgery, University of Rome “Sapienza”, Rome, Italy
3Department of Neurological Surgery, Wexner Medical Center, The Ohio State University College of Medicine, Columbus, OH, USA
4Department of Neurosurgery, King’s College of London, London, UK

Received 7 August 2015; Accepted 5 October 2015

Academic Editor: Panagiotis Korovessis

Copyright © 2015 Giulio Anichini et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Endoscopic disc surgery (EDS) for lumbar spine disc herniation is a well-known but developing field, which is increasingly spreading in the last few years. Rate of recurrence/residual, complications, and outcomes, in comparison with standard microdiscectomy (MD), is still debated and need further data. We performed an extensive review based on the last 6 years of surgical series, systematic reviews, and meta-analyses reported in international, English-written literature. Articles regarding patients treated through endoscopic transforaminal or interlaminar approaches for microdiscectomy (MD) were included in the present review. Papers focused on endoscopic surgery for other spinal diseases were not included. From July 2009 to July 2015, we identified 51 surgical series, 5 systematic reviews, and one meta-analysis reported. In lumbar EDS, rate of complications, length of hospital staying, return to daily activities, and overall patients’ satisfaction seem comparable to standard MD. Rate of recurrence/residual seems higher in EDS, although data are nonhomogeneous among different series. Surgical indication and experience of the performing surgeon are crucial factors affecting the outcome. There is growing but still weak evidence that lumbar EDS is a valid and safe alternative to standard open microdiscectomy. Statistically reliable data obtained from randomized controlled trials (better if multicentric) are desirable to further confirm these results.