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International Orthopaedics

, Volume 43, Issue 4, pp 917–922 | Cite as

Minimally invasive discectomy for lumbar disc herniation: current concepts, surgical techniques, and outcomes

  • Haruo KannoEmail author
  • Toshimi Aizawa
  • Ko Hahimoto
  • Eiji Itoi
Review

Abstract

Purpose

To date, various minimally invasive surgeries for lumbar disc herniation (LDH) have been performed in many countries, including microendoscopic discectomy (MED) and percutaneous endoscopic discectomy (PED). We herein report the surgical indications, current concepts, and techniques of minimally invasive discectomy for LDH, including MED and PED. The postoperative outcomes and risks of complications compared with conventional discectomy are also discussed.

Methods

By reviewing past literatures, the current concepts, surgical techniques, and clinical outcomes were described.

Results

Minimally invasive discectomy is generally performed using a transmuscular approach with an endoscopic technique and can reduce muscle and soft tissue damage. The minimal invasiveness can also reduce the severity of postoperative pain and improve patient satisfaction compared with conventional open discectomy. Based on the data of previous systematic reviews and meta-analyses, minimally invasive lumbar discectomy, such as MED and PED, appears to be safe and effective alternatives to open discectomy for patients with symptomatic LDH. These minimally invasive surgeries can provide beneficial effects to shorten the hospital stay and time to return to work. However, minimally invasive discectomy has a demanding learning curve. Only a well-trained surgeon and support team should perform these less invasive procedures.

Conclusions

Clinical evidence supporting the superiority of MED and PED is still limited. Well-designed prospective multicentered randomized controlled trials with large samples are therefore needed in order to draw a convincing conclusion.

Keywords

Disc herniation Lumbar spine Discectomy Minimally invasive surgery Endoscopic surgery 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryTohoku University Graduate School of MedicineSendaiJapan

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