Percutaneous Endoscopic Transforaminal Discectomy vs Conventional Open Lumbar Discectomy for Lumbar Disc Herniation: A Systematic Review

Introduction: Despite the fact that there are various surgical procedures for lumbar disc herniation, open lumbar microdiscectomy is the most effective. Percutaneous endoscopic lumbar discectomy has recently become a popular procedure for treating herniated lumbar discs.

Objectives: The aim of this study is to determine whether percutaneous endoscopic lumbar discectomy and conventional open lumbar discectomy show better results as a surgical treatment of lumbar disc herniation. To evaluate the surgical outcomes and advantages of each technique as well as to describe the technical strategy and evaluate the outcomes of the PETD technique specific to LDH.

Methods: In this review's analysis, studies examining endoscopic percutaneous endoscopic transforaminal discectomy and conventional open discectomy—both surgical procedures for treating herniated lumbar discs—were looked at. In the Google Scholar and PubMed databases, papers published between 1973, the year percutaneous endoscopic lumbar discectomy was first introduced, and 2022 were searched.

Results: The 8 publications that had 5,314 patients were chosen. Percutaneous endoscopic lumbar discectomy has a noticeably better outcome than open lumbar microdiscectomy, according to the comparative study. All procedures have good results, as seen by the comparison between PETD operations and traditional surgical discectomy. A better visual analog pain scale (VAS), a better confidence interval, reduced blood loss, a shorter operating time, a shorter length of stay, fewer complication rates, lower recurrence rates, and a low reoperation rate are some benefits of the PETD method.

Conclusion: Although percutaneous endoscopic lumbar discectomy exhibits superior outcomes to traditional surgical discectomy in a number of areas. The traditional open discectomy still yields positive clinical outcomes. In order to compare these two surgical approaches, it is anticipated that a systematic review trial with a sizable research sample and more literature would be required in the future.