A Comparison of Microdiscectomy to Microendoscopic Discectomy

Introduction:

The increasing use of alternative methods for disc decompression demands a critical review and comparison to the standard technique. Microendoscopic discectomy has been hailed as one of the newest and best methods for disc removal as minimally invasive techniques have gained popularity across surgical specialties.

Study Design:

A prospective analysis of 'standard' microdiscectomy and microendoscopic discectomy was done over a two year period. Patient outcome, hospitalization time, operative time, complications, and cost were compared. Thirty patients were entered into each group.

Results:

Microdiscectomy can be performed in a much briefer period of time than with the endoscopic technique. The complication rate is equivalent in the two populations, but the need to convert to an open procedure is only seen in MED. As compared to outpatient microdiscectomy, MED patients require a similar hospitalization time. The use of narcotic analgesia was the same in the two groups, but the need for muscle relaxants was higher in the MED group. Cost was significantly reduced in the microdiscectomy group.

Discussion & Conclusion:

MED offers no advantage over microdiscectomy in terms of patient satisfaction or hospitalization time. MED failed to lower cost, and, in fact, caused a significant increase in cost in terms of equipment, and OR time.