Microendoscopic Discectomy Versus Open Discectomy for Lumbar Disc Herniation: A Meta-Analysis

Eur Spine J. 2016 May;25(5):1373-1381. doi: 10.1007/s00586-016-4523-3. Epub 2016 Mar 21.


Purpose: To compare the outcomes of microendoscopic discectomy and open discectomy for patients with lumbar disc herniation.

Methods: An extensive search of studies was performed in PubMed, Medline, Embase, Cochrane library and Google Scholar. The following outcome measures were extracted: visual analogue scale (VAS), Oswestry disability index (ODI), complication, operation time, blood loss and length of hospital stay. Data analysis was conducted with RevMan 5.0.

Results: Five randomized controlled trials involving 501 patients were included in this meta-analysis. The pooled analysis showed that there was no significant difference in the VAS, ODI or complication between the two groups. However, compared with the open discectomy, the microendoscopic discectomy was associated with less blood loss [WMD = -151.01 (-288.22, -13.80), P = 0.03], shorter length of hospital stay [WMD = -69.33 (-110.39, -28.28), P = 0.0009], and longer operation time [WMD = 18.80 (7.83, 29.76), P = 0.0008].

Conclusions: Microendoscopic discectomy, which requires a demanding learning curve, may be a safe and effective alternative to conventional open discectomy for patients with lumbar disc herniation.

Keywords: Discectomy; Endoscopic; Lumbar disc herniation; Microendoscopic.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Diskectomy* / adverse effects
  • Diskectomy* / methods
  • Diskectomy* / statistics & numerical data
  • Endoscopy
  • Female
  • Humans
  • Intervertebral Disc Displacement / surgery*
  • Lumbar Vertebrae / surgery*
  • Male
  • Microsurgery* / adverse effects
  • Microsurgery* / methods
  • Microsurgery* / statistics & numerical data
  • Middle Aged
  • Randomized Controlled Trials as Topic