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European Spine Journal
Published in: European Spine Journal 2/2010

Open Access 01-02-2010 | Review Article

Transforaminal endoscopic surgery for symptomatic lumbar disc herniations: a systematic review of the literature

Authors: Jorm Nellensteijn, Raymond Ostelo, Ronald Bartels, Wilco Peul, Barend van Royen, Maurits van Tulder

Published in: European Spine Journal | Issue 2/2010

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Abstract

The study design includes a systematic literature review. The objective of the study was to evaluate the effectiveness of transforaminal endoscopic surgery and to compare this with open microdiscectomy in patients with symptomatic lumbar disc herniations. Transforaminal endoscopic techniques for patients with symptomatic lumbar disc herniations have become increasingly popular. The literature has not yet been systematically reviewed. A comprehensive systematic literature search of the MEDLINE and EMBASE databases was performed up to May 2008. Two reviewers independently checked all retrieved titles and abstracts and relevant full text articles for inclusion criteria. Included articles were assessed for quality and outcomes were extracted by the two reviewers independently. One randomized controlled trial, 7 non-randomized controlled trials and 31 observational studies were identified. Studies were heterogeneous regarding patient selection, indications, operation techniques, follow-up period and outcome measures and the methodological quality of these studies was poor. The eight trials did not find any statistically significant differences in leg pain reduction between the transforaminal endoscopic surgery group (89%) and the open microdiscectomy group (87%); overall improvement (84 vs. 78%), re-operation rate (6.8 vs. 4.7%) and complication rate (1.5 vs. 1%), respectively. In conclusion, current evidence on the effectiveness of transforaminal endoscopic surgery is poor and does not provide valid information to either support or refute using this type of surgery in patients with symptomatic lumbar disc herniations. High-quality randomized controlled trials with sufficiently large sample sizes are direly needed to evaluate if transforaminal endoscopic surgery is more effective than open microdiscectomy.
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Metadata
Title
Transforaminal endoscopic surgery for symptomatic lumbar disc herniations: a systematic review of the literature
Authors
Jorm Nellensteijn
Raymond Ostelo
Ronald Bartels
Wilco Peul
Barend van Royen
Maurits van Tulder
Publication date
01-02-2010
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 2/2010
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-009-1155-x

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