Title: Comparison of open discectomy with micro endoscopic discectomy in lumbar disc herniation: a systematic review

OBJECTIVE: Lumbar disc herniation is a prevalent cause of discectomy. Surgical discectomies is performed either through an open approach or using the more modern microscopic and endoscopic approaches. The purpose of this study is to compare the outcomes of micro endoscopic discectomy and open discectomy for lumbar disc herniation. METHODS: In this systematic review، the information was searched from Iran-Medex, Irandoc, and also in international databases; PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), SCOPUS and EMBASE, between 1991 to 2019 with keywords of open discectomy، micro endoscopic discectomy. Then the articles which obtained the patients with lumbar disc herniation were entered to the study. Postoperative neurological status, pain, and functional outcome were evaluated. Other studied variables were the duration of the procedure, blood loss, time of hospital stay, and time to return to work.RESULTS: The reported prevalence is presented as percent and 95% confidence interval. The search yielded 304 publications that were related to inclusion criteria. According to titles, 116 publications were excluded as clearly ineligible, leaving 14 for further review. Both methods are equally effective in pain. Surgical and anesthesia times were significantly longer but blood loss was reduced in patients having micro endoscopic discectomy than open discectomy. Micro endoscopic discectomy entailed size of short incision، shorter hospital stay، less morbidity and earlier return to work.CONCLUSION: Although the measure of satisfactory outcomes was approximately the same in both groups، the patients who had had a micro endoscopic discectomy had a shorter duration of postoperative inability and used narcotics for a shorter course. These findings suggest that، micro endoscopic discectomy may be beneficial for the operative treatment of lumbar disc herniation. In addition, the surgeon must be familiar with this method and must be trained in its use.

کلیدواژه ها:

open discectomy ، micro endoscopic discectomy ، lumbar disc herniation.