Comparison of Endoscope-Assisted and Microscope-Assisted Tubular Surgery for Lumbar Laminectomies and Discectomies: Minimum 2-Year Follow-Up Results

Abstract

Purpose. This study aimed to evaluate the clinical outcomes of endoscope-assisted and microscope-assisted tubular surgery for lumbar laminectomies and discectomies. Methods. Three hundred and seven patients with lumbar spinal stenosis (LSS) or lumbar disc herniation (LDH) at L3-4, L4-5, and L5-S1 were included in this study. The patients were treated with endoscope-assisted or microscope-assisted tubular surgery. Data on patient demographic characteristics and operative results, including ages, blood loss, operative times, hospital stay, and surgical complications were collected. Clinical outcomes were assessed based on pre- and postoperative Visual Analog Scale (VAS) scores for low-back pain (LBP) and leg pain, Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scale. Results. Both tubular-based endoscope-assisted and microscope-assisted surgery were effective in relieving acute radicular symptoms. The results showed characteristic differences in operating times between endoscope-assisted and microscope-assisted procedures and between discectomies and laminectomies. At the last follow-up, VAS scores of LBP and leg pain, JOA scores, and ODI scores were significantly better than preoperative correlates in all groups. There were no differences between endoscope-assisted and microscope-assisted discectomies for LDH in JOA scores, ODI scores, and VAS scores, while the microscope-assisted laminectomies related to better JOA recovery rate for LSS. Conclusions. Endoscope-assisted and microscope-assisted tubular discectomies resulted in similar clinical outcomes for LDH, while the microscope-assisted surgery may relate to better recovery rate for LSS, less surgical time, and less intraoperative dural tear.