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SICOT2018: Better perioperative measures and patient satisfaction with endoscopic vs open discectomy
April 2025
SICOT2018: Better perioperative measures and patient satisfaction with endoscopic vs open discectomy
Study Type:Meta analysis
OE Level Evidence:N/A
Journal Level of Evidence:N/A
A META-ANALYSIS OF ENDOSCOPIC DISCECTOMY VERSUS OPEN DISCECTOMY FOR SYMPTOMATIC LUMBAR DISC HERNIATION
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CONFERENCE ACE REPORTS
This ACE Report is a summary of a conference presentation or abstract. The information provided has limited the ability to provide an accurate assessment of the risk of bias or the overall quality. Please interpret the results with caution as trials may be in progress and select results may have been presented.
Synopsis
9 randomized controlled trials were included in this meta-analysis, which compared outcomes between endoscopic discectomy and open discectomy in patients undergoing treatment for lumbar disc herniation. For perioperative measures, endoscopic discectomy was significantly favoured for both blood loss and length of hospital stay. Postoperatively, patient satisfaction rates were significantly higher in endoscopic discectomy groups, while there was no significant difference between groups observed in grading of postoperative function through the Macnab criteria.
Why was this study needed now?
Discectomy is often undergone following cases of lumbar disc herniation. Discectomy can be completed via a number of different techniques, including either open or endoscopic surgery. Despite previous randomized controlled trials on the topic, there is uncertainty if outcomes significantly differ between the open and endoscopic discectomy.
What was the principal research question?
In lumbar discectomy following lumbar disc herniation, is there a significant difference in perioperative measures, patient satisfaction, or postoperative function between endoscopic discectomy and open discectomy?
Study Characteristics
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Data Source:
Sources used to identify relevant literature were not reported in the conference abstract.
Index Terms:
Search strategy was not reported in the conference abstract.
Study Selection:
Eligibility criteria included: a randomized controlled trial design; enrolled patients scheduled for lumbar discectomy; and allocated patients to either endoscopic discectomy or open discectomy. A total of 9 studies were selected for final inclusion.
Data Extraction:
Details on data extraction were not reported in the conference abstract.
Data Synthesis:
Details on methods of statistical analysis were not reported in the conference abstract.
What were the important findings?
- Blood loss was significantly lower among endoscopic discectomy groups compared to open discectomy groups (MD -123.71mL [95%CI -173.47, -73.95]; p<0.00001).
- Length of hospital stay was significantly shorter among endoscopic discectomy groups compared to open discectomy groups (MD -144.45 [95%CI -239.54, -49.37]; p=0.003).
- Rate of patient satisfaction postoperatively was significantly higher among endoscopic discectomy groups (93.21%) compared to open discectomy groups (86.57%) (OR 2.19 [95%CI 1.09-4.40]; p=0.03).
- Grading of postoperative function using the Macnab criteria did not significantly differ between endoscopic discectomy groups and open discectomy groups (OR 3.72 [95%CI 0.76-18.14]; p=0.10).
What should I remember most?
In treatment of lumbar disc herniation, endoscopic discectomy was associated with reduced blood loss, shorter length of hospital stay, and greater patient satisfaction when compared to open discectomy, though no significant difference in postoperative function was observed between endoscopic and open discectomy.
How will this affect the care of my patients?
The results of this study suggest that endoscopic discectomy may be an effective alternative to open discectomy for patients undergoing lumbar discectomy following disc herniation. Continued study through randomized controlled trials is needed, with additional emphasis placed on potential complications and costs associated with each.
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Orthopaedic Surgeon - China
How about re-surgery rate?