BioMed Research International / 2015 / Article / Tab 1

Review Article

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

Table 1

Series reported in the literature in the last 6 years. FED: full endoscopic discectomy; MED: microendoscopic discectomy; EDS: endoscopic discectomy; MD: microdiscectomy; TF: transforaminal; IL: interlaminar; OC: outcome; DVT: deep venous thrombosis. When reported alone, values are referred only to as recurrence rate.

First authorYearStudy Number of pts.Techn.OC measuresOutcomeRecurrence rate/residual/redoComplications

Li [21]2015EDS, comparison between FED and MED65TF and ILVAS and ODINo differences, shorter hospital staying in FED group8,6% FED; 6,7% MED1 dural tear
Türk [22]2015Surgical series EDS105TFVAS and ODI90,4% pain relief2 redo surgeriesNot mentioned
Wang [23]2015Surgical series EDS207TFVAS, ODI, and MacNab71–86% excellent OC, age related3 to 5% age-related3 dural tears, 1 postop instability
Li [24]2015Surgical series EDS72ILVAS, ODI, and MacNab97% good to excellent OC1No complications noted
Sairyo [25]2014Surgical series EDS, analysis of complications100TF and IL2% nerve injury; 1% postop hematoma
Liao [26]2014Surgical series EDS15TFVAS and MacNab93% good to excellent OC
Sencer [27]2014Surgical series EDS163TF and ILVAS and ODI88% good to excellent OC8 (5%)6 (3%) dural tears; 5 (2,9%) types of postop worsening
Yoshimoto [28]2014Surgical series EDS, comparison between far lateral and intraforaminal disc herniations removal25 (far lateral) + 93 (IL)TFVAS and JOANo significant differences in pain relief between the two groups
Jasper [29]2014Surgical series EDS, comparison between transforaminal and interlaminar approaches41TF and ILVAS and MacNab75% pain relief in both groupsNo complications noted
Xu [30]2014Surgical series EDS, analysis of learning curve36ILVASExcellent outcome2 pts. converted to open surgeryNo complications noted
Hussein [31]2014Comparison between EDS and MD185ILNRS, MacNab, and ODIStatistically significant pain relief in both groups2; 8 converted to open surgery3 dural tears
Kulkarni [32]2014Surgical series EDS188ILVAS and ODIStatistically significant pain relief3 (1,5%)11 (5%) dural tears, 1 (0,5%) infection, and 1 (0,5%) wrong level
Choi [33]2013Surgical series EDS, comparison between transforaminal and interlaminar approaches30TF and ILVAS and ODIShorter recovery time in interlaminar3,3% TF; 6,7% IL6,7% postop dysesthesia
Wang [34]2013Surgical series EDS, comparison between early and delayed surgery145VAS and MacNabNo significant differences in pain relief between the two groups8 to 11% redoNo complications noted
Kim [12]2013Surgical series EDS, comparison between interlaminar approach alone and interlaminar + annular sealing224ILVAS and ODIStatistically significant pain relief in both groups5% IL + sealing; 13% IL alone
Yoshimoto [35]2013Surgical series EDS25JOA80,4% of pain improvement0No complications noted
Jasper [3638]2013Surgical series EDS195TFVAS83,9% improvement in single level pathology; 69,7% improvement in multilevel
Wang [39]2013Surgical series EDS, analysis of learning curve (comparison between 2 groups operated on by surgeons with different level of training)120TFVAS and JOASignificant improvements in both groups20 residuals, 14 (23%) group A; 6 (10%) group B; 2 recurrences2 postop infections
Choi [33]2013Surgical series EDS, intraop magnetic imaging89TFVAS, ODI, and MacNabSignificant improvement4 (4,5%) residuals; 2 (2%) recurrences2 postop hematomas
Jasper [3638]2013Surgical series EDS50TFVAS71 to 75% pain relief10%No complications
Yadav [40]2013Surgical series EDS400ILVAS and MacNab90% significant improvement2 (0,5%)3 facet injuries; 7 dural tears; 2 infections; 1 persistent paresthesias
Soliman [41]2013Surgical series EDS41ILVAS and ODI95% excellent to good improvement12 dural tears
Matsumoto [42]2013Surgical series EDS, analysis of recurrences344JOA75 to 83% recovery rate37 (10,8%)
Hsu [43]2013Comparison between EDS and MD59TF and ILVAS and ODINo significant differences between EDS and standard microdiscectomy groups2 recurrences, 4 persistent symptoms2 nerve root injuries
Chaichankul [44]2012Surgical series EDS, analysis of learning curve50TFVASSignificant improvement in both groups, higher in later stages of learning curve
Kim [45]2012Surgical series EDS for migrated discs18ILMacNab89% of complete removal2 residuals1 dural tear
Hirano [46]2012Surgical series EDS37TF and ILVAS and JOASignificant improvement2
Yoon [47]2012Surgical series, comparison of EDS and tubular-retractor microdiscectomy37 EDS + 35 MDTFVAS, ODI, and SF-36No significant differences between EDS and standard microdiscectomy groups1 in each group1 dural tear; 1 bowel perforation
Wang [48]2012Surgical series EDS151MacNab91% good to excellent OC5 (3,5%)5 pts. (3,5%) dural tears; 3 pts. (2,1%) discitis
Lübbers [49]2012Surgical series EDS22TF and ILVAS, ODI, and MacNab18 pts. (81%) good OC2 (9,1%)1 stroke
Han [50]2012Surgical series EDS, analysis of technique41TFMacNab39 pts. excellent to good OC2 nerve root injuries
Kaushal [51]2012Surgical series EDS300ILMacNab90% excellent to good OC6 discitis cases; 5 dural tears; 2 nerve root injuries
Kim [45]2012Surgical series EDS, analysis of technique30ILSignificant improvementNo complications noted
Tenenbaum [52]2011Surgical series EDS, analysis of technique, complications, and learning curve124TFVAS and ODIOC comparable to open surgery20,9% redo surgery1,6% complication rate
Chumnanvej [53]2011Surgical series EDS60ILMacNab91,6% excellent outcome2No complications
Cho [54]2011Surgical series EDS, analysis of complications154TFVAS and ODISignificant improvement3 (1,95%)1 dural tear; 1 discitis
Choi [55]2011Surgical series EDS, focused on annuloplasty and LBP improvement52TFVAS and ODI78,4% improvement18 residuals; 2 recurrencesNo complications noted
Chen [56]2011Surgical series EDS, focused on anesthesia123ILVAS and ODISignificant improvements in both groups31 dural tear
Dezawa [57]2011Surgical series EDS, focused on technique30ILSignificant improvement1 persistent radiculopathy
Garg [58]2011Comparison between EDS and MD112TFODIStatistically significant pain relief in both groups1EDS, 5 dural tears
Doi [59]2011Surgical series EDS17TF and ILJOA16 pts. significant improvement3No complications noted
Casal-Moro [60]2011Surgical series EDS120TF and ILVAS and ODI92% good to excellent OC7,5% redo surgery4,1% dural tear; 4 nerve root injuries; 1 DVT; 1 discitis
Wang [61]2011Surgical series EDS, analysis of learning curve30ILVASSignificant improvement20% converted to open12 to 10%, depending on the group
Lee et al. [62]2010Surgical series EDS25TFVAS and ODISignificant improvement1 residual; 1 recurrenceNo complications noted
Ahn [63]2010Surgical series EDS, focused on annuloplasty and LBP improvement87TFVAS, ODI, and MacNab72% good to excellent OC13 converted to openNo complications noted
Jhala and Mistry [64]2010Surgical series EDS100ILMacNab91% good to excellent OC44 discitis cases; 1 nerve root damage
Teli [65]2010Comparison between EDS and MD, focused on complications224VAS, ODI, and SF-36Higher rate of complications in EDS group86 dural tears; 2 nerve injuries; 1 discitis
Peng [66]2010Surgical series EDS55VAS, NASS, and SF-36Significant improvement5%
Lee [67]2009Comparison between EDS and MD54—25 EDS, 29 MDTFVAS and ODISignificant improvement in both groups, but reduction in hospital staying and recurrence rate in EDS group1 EDS persistent pain; 4%1 unspecified complication
Chae [68]2009Surgical series EDS, analysis of technique153TFVAS and MacNab94% excellent to good OCNot reported1 paravertebral hematoma; 3 transient pareses; 8 transient hypoesthesia cases
Zhou [69]2009Surgical series EDS275TFMacNab91% good to excellent OC55 dural tears; 3 infections

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