Table 6.
Characteristics of the included studies comparing open versus microscopic and comparable discectomy
| Author, year | Sample size | Female (%) | Average age (range/SD) | Participants | Interventions | Outcomes | Follow-up |
|---|---|---|---|---|---|---|---|
| Henriksen 1996 [28] | 79 | 37 | 41 (30–48) | HNP, 20 to 60 years, failed conservative therapy (bed rest, analgesics,muscle relxers, physiotherapy), myelogram, CT verified |
Open (standard) discectomy (OD) Microscopic discectomy (MD) |
Incision, OP time, LOS Pain medication Pain (VAS) |
2, 4, 6 days 2, 4, 6 weeks |
| Hermantin 1999 [29] | 60 | 35 | 40 (15–67) | Low back pain and radicular symptoms, confirmed by imaging, due to single level intercanalicular HNP at L2-S1. < 50 % canal, no osseous or ligamenteous stenosis, failed conservative treatment, back pain > leg pain, no severe disc height loss |
Open laminectomy and discectomy (OD) Video assisted arthroscopic microdiscectomy (VAMD) |
Self evaluation Physical examination Return to function Pain (Houde) Satisfaction Return to work |
2 weeks 3, 6 months 1, 2 years |
| Huang 2005 [30] | 22 | 32 | 39.4 (10.9) | Failed conservative treatment (3 months), OR Acute attack of intractable back and leg pain, no improvement 1–2 weeks bedrest. No motor deficit or sphincter disturbance |
Open discectomy (OD) Microendoscopic discectomy (MED) |
OP time, Blood loss, LOS Interleukines and CRP Pain (VAS) MacNab |
18.9 months (10–25) |
| Katayama 2006 [32] | 119 | 36 | 37 (14–65) | Primary surgery for HNP |
Open (macro) discectomy (OD) Microscopic discectomy (MD) |
OP time, Blood loss, LOS Pain medication JOA VAS back pain VAS sciatica Complications/reoperations |
2.67 years (1–4) |
| Lagarrigue 1994 [33] | 80 | 49 | 43 (15–80) | HNP with sciatica, failed conservative treatment (3 months), CT confirmed. No paralysis, stenosis, degenerative changes |
Open discectomy (OD) Microscopic disectomy (MD) |
MacNab OP time, LOS RTW |
14.9 months (12–18) |
| Teli 2010 [43] | 240 | 34 | 39.3 (27–61) | Symptomatic, single-level HNP, 18–65 years, concordant neurological signs, failed conservative treatment (6 weeks, pain medication, epidural steroids), no additional spinal disorders |
Open discectomy (OD) Microscopic discectomy (MD) Microendoscopic discectomy (MED) |
OP time, Incision Back pain (VAS) Leg pain (VAS) Oswestry disability SF36 Cost |
10 days 6, 12, 24 months |
| Tullberg 1993 [45] | 60 | 35 | 39 (17–64) | Single lumbar disc herniation, failed conservative treatment (2 months), CT verified |
Open (standard) discectomy (OD) Microscopic discectomy (MD) |
OP time, Blood loss, LOS Back pain (VAS) Leg pain (VAS) Satisfaction |
3 weeks 2, 6, 12 months |
| Tureyen 2003 [46] | 114 | 43 | 41.6 (18–61) | Lumbar disc herniation, leg pain, MRI verified |
Laminectomy and macrodiscectomy (OD) Microscopic discectomy (MD) |
OP time, LOS, incision Radicular pain (VAS) Muscle strength (MRC) Sensation Reflex |
10 days 1 month 1 year |
LOS Length of stay, RTW Return to work, JOA Japanese Orthopaedic Association score