Sciatica Research - Treatment, Prevention, Medication

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Comparison of open discectomy with microendoscopic discectomy in lumbar disc herniations: results of a randomized controlled trial.

Righesso O, Falavigna A, Avanzi O

Department of Orthopedics, Santa Casa School of Medicine and Hospitals of São Paulo, São Paulo, Brazil. righesso@superig.com.br

OBJECTIVE: We compared the intra- and postoperative differences, as well as the final outcome of patients with herniated lumbar discs who underwent either open discectomy (OD) or microendoscopic discectomy (MED). METHODS: We performed a prospective controlled randomized study of 40 patients with sciatica caused by lumbar disc herniations nonresponsive to conservative treatment who underwent OD or MED with a 24-month follow-up period. Pre- and 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. Statistical analysis with a P value less than 0.005 was carried out. RESULTS: The only statistically significant differences found were for size of the incision, length of hospital stay, and operative time. The former two were greater in the OD group (P < 0.01 and P = 0.05, respectively), and the latter was greater in the MED group (P < 0.01). CONCLUSION: The few parameters that were found to be statistically significant between the groups did not affect the overall outcome. In the current series, the final clinical and neurological results were similarly satisfactory in both the OD and the MED groups.

Published 20 September 2007 in Neurosurgery, 61(3): 545-9; discussion 549.
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