Table 4.
Summary of Literature Review: Endoscopic Versus Nonendoscopic Decompression.
| Authors (Year) | Title | Source | Study Design | Findings |
|---|---|---|---|---|
| Polikandriotis et al (2013) | Minimally invasive surgery through endoscopic laminotomy and foraminotomy for the treatment of lumbar spinal stenosis | Journal of Orthopaedics | Prospective observational study/cohort | Endoscopic minimally invasive surgery for the treatment of LSS allows for short operative times, low complication rates, and minimal EBL, along with postoperative improvement of pain and disability as reported by patients. |
| Phan and Mobbs (2016) | Minimally invasive versus open laminectomy for lumbar stenosis: a systematic review and meta-analysis | Spine | Systematic review and meta-analysis | When comparing the outcomes of ULBD to open laminectomy, there is higher patient satisfaction and lower back pain VAS scores, a decrease in blood loss, and is associated with shorter hospitalization. |
| Qin et al (2018) | Percutaneous endoscopic lumbar discectomy versus posterior open lumbar microdiscectomy for the treatment of symptomatic lumbar disc herniation: a systemic review and meta-analysis | World Neurosurgery | Systematic review and meta-analysis | PELD and OLMD when compared displayed no statistically significant differences in preoperative and postoperative VAS score for sciatica and ODI, as well as operation time, complication rate, and incidence of recurrence and reoperation. PELD resulted in a higher incidence for residual disk or incomplete decompression, but shorter hospitalization and time to return to work when compared with the OLMD group |
| Zhang et al (2018) | Transforaminal endoscopic discectomy versus conventional microdiscectomy for lumbar disc herniation: a systematic review and meta-analysis | Journal of Orthopaedic Surgery and Research | Systematic review and meta-analysis | As indicated through the meta-analysis, transforaminal endoscopic discectomy and conventional microdiscectomy were significantly different in terms of length of stay but displayed no significant differences in terms of leg VAS scores, ODI scores, and incidence of complications and recurrence |
| Kim et al (2018) | Trans-sacral epiduroscopic laser decompression versus the microscopic open interlaminar approach for L5-S1 disc herniation | The Journal of Spinal Cord Medicine | Retrospective analysis | In L5-S1 disc herniation patients, both SELD and OLD significantly improved leg and back pain as quantified by ODI and VAS scores at 6 months after the procedure. The SELD procedure allowed for a shorter time to return to work compared with the OLD group |
| Bresnahan et al (2017) | Assessment of paraspinal muscle cross-sectional area after lumbar decompression: minimally invasive versus open approaches | Clinical Spine Surgery | Retrospective analysis | When assessing for paraspinal muscle cross-sectional area following lumbar decompression, the MEDS approach better preserved the paraspinal muscle CSA than the open approach |
| Oichi et al (2018) | In-hospital complication rate following microendoscopic versus open lumbar laminectomy: a propensity score-matched analysis | The Spine Journal | Retrospective cohort study | MEL and open laminectomy when compared, demonstrated a significantly lower incidence of postoperative complications, surgical site infections, and postoperative delirium in the MEL group than in the open laminectomy group. There was no significant difference when comparing for in hospital mortality. |
| Garg et al (2011) | Microendoscopic versus open discectomy for lumbar disc herniation: a prospective randomised study | Journal of Orthopaedic Surgery | Prospective randomized study | When comparing MED and open discectomy for lumbar disc herniation, MED provided a shorter length of stay, less morbidity, and an early return to work when compared with the open discectomy group. Both interventions were effective in providing radicular pain relief. |
| Allen and Garfin (2010) | The economics of minimally invasive spine surgery: the value perspective | Spine | Literature review | The cost-effectiveness of MIS techniques is questioned as the quality of data available to determine cost benefits is low. Previous MIS endoscopic/nonendoscopic techniques, although yielding lower morbidities, were available at a high cost to the patient and introduced new set of postoperative complications. With newer MIS techniques becoming available, the cost-effectiveness is becoming dependent on maintenance of improved clinical outcomes for the patient, which includes lower rates of complications, shorter length of stay, and less blood loss. |
| Schöller et al (2017) | Lumbar spinal stenosis associated with degenerative lumbar spondylolisthesis: a systematic review and meta-analysis of secondary fusion rates following open vs minimally invasive decompression | Neurosurgery | Systematic review and meta-analysis | In patients with LSS with degenerative spondylolisthesis, minimally invasive unilateral laminotomy was associated with lower rates of reoperation and fusion, less slip progression, and greater patient satisfaction compared with open decompression surgery. |
| Ahn et al (2016) | Comparison of outcomes of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for young adults: a retrospective matched cohort study | World Neurosurgery | Retrospective cohort study | PELD and OLM for lumbar disc herniation produced similar results for leg pain and radiologic results. However, PELD was associated with superior back pain improvement, operation time, blood loss, length of stay, and return to work. |
| Lee et al (2006) | Comparative radiologic evaluation of percutaneous endoscopic lumbar discectomy and open microdiscectomy: a matched cohort analysis | The Mount Sinai Journal of Medicine | Retrospective matched cohort | PELD and OLM yielded similarly successful clinical outcomes. However, PELD was associated with significantly higher disc height and lower foraminal height. |
| Ruan et al (2016) | Comparison of percutaneous endoscopic lumbar discectomy versus open lumbar microdiscectomy for lumbar disc herniation: a meta-analysis | International Journal of Surgery | Meta-analysis | PELD holds no advantage over OLM in terms of functional outcomes, complication rates, and reoperation rates. However, PELD was associated with shorter operation times and hospital lengths of stay in the setting of lumbar disc herniation. |
| Lee et al (2009) | Comparison of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for recurrent disc herniation | Journal of Korean Neurosurgical Society | Retrospective analysis | Percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy produced favorable outcomes for treatment of recurrent disc herniation. However, percutaneous endoscopic lumbar discectomy was associated with shorter operating times, shorter hospital stays, and disc height preservation. |
| Shih et al (2011) | Complications of open compared to minimally invasive lumbar spine decompression | Neuroscience | Retrospective case series | Microendoscopic decompression were associated with longer operative times but had decreased blood loss, shorter hospital stays, and decreased requirements for support services following discharge |
| Choi et al (2016) | Percutaneous endoscopic lumbar discectomy as an alternative to open lumbar microdiscectomy for large lumbar disc herniation | Pain Physician | Retrospective assessment | Compared with open lumbar microdiscectomy, percutaneous endoscopic lumbar discectomy was associated with higher surgical satisfaction rates, faster recovery, improvements in back pain, and disc height preservation in the setting of lumbar disc herniation. |
Abbreviations: PELD, percutaneous endoscopic lumbar discectomy; OLM/OLMD, open lumbar microdiscectomy; VAS, visual analogue scale; ODI, Oswestry Disability Index; ULBD, unilateral laminectomy for bilateral decompression; LSS, lumbar spine stenosis; SELD, trans-sacral epiduroscopic laser decompression; OLD, open lumbar discectomy; MIS, minimally invasive surgery; CSA, cross-sectional area; MEDS, microendoscopic decompression of stenosis; MEL, microendoscopic laminectomy; EBL, estimated blood loss.