Endoscopic Discectomy or Microdiscectomy?Which Surgical Method Is More Appropriate for Lumbar Disc Herniation?

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In recent years, different surgical techniques have come to the forefront in the treatment of lumbar and cervical disc herniations. Among these, endoscopic discectomy and microdiscectomy stand out as minimally invasive (small-incision) surgical methods. So, what are the differences between these two techniques, and which one is more suitable for which patient?

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What is Microdiscectomy?

Microdiscectomy is a high-precision surgical procedure for lumbar disc herniation performed with the assistance of an operating microscope. Through a small skin incision, the surgeon removes the disc material that is compressing the affected nerve. The use of the microscope allows clear visualization of the nerve structures, which helps minimize the risk of nerve injury and improves surgical safety.

Advantages:

• High success rates, with clinical improvement reported in up to 90% of patients

• Enhanced nerve safety due to direct visualization of neural structures

• Lower likelihood of requiring repeat surgery

• Short hospital stay, typically one day

• Early mobilization, with patients able to stand and walk on the same day and return to daily activities within one week

What is Endoscopic Discectomy?

Endoscopic discectomy is another minimally invasive surgical technique performed using a very thin instrument. In this procedure, the herniated disc material is removed with the help of a camera and specialized instruments. The skin incision is very small; however, compared to microdiscectomy, direct visualization of the nerves during the procedure is more limited.

Disadvantages:

• The visual field is not as wide as with microscopic surgery

• The risk may be higher in disc herniations located very close to the nerve

• In some clinical series, the risk of recurrent disc herniation is higher

• Not suitable for every patient, particularly in cases of broad-based disc herniations

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Why Do We Prefer Microdiscectomy for Lumbar Disc Herniation Surgery?

With the use of state-of-the-art surgical microscopes and refined operative techniques, microdiscectomy continues to be regarded as the gold standard for lumbar disc herniation surgery, offering a proven balance of safety and clinical effectiveness. Especially in patients with significant nerve compression and typical lumbar disc herniation, microscope-assisted surgery offers safer and more durable long-term results.

In addition, when compared with endoscopic techniques, microdiscectomy offers:

• Higher long-term patient satisfaction

• A wider and more controllable surgical field for the surgeon

• A lower risk of recurrence

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Conclusion: Which Lumbar Disc Herniation Surgery Is Right for You?

Every patient is different. The choice of surgical technique depends on several factors, including the size and location of the disc herniation, the patient’s overall health status, and whether they have had previous spine surgery. However, in cases of typical lumbar disc herniation with significant nerve compression, microdiscectomy remains the most robust option, offering superior surgical control and a high level of patient safety.

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Consult a Specialist: When deciding between endoscopic discectomy and microdiscectomy, the most appropriate choice should be made after a thorough evaluation by an experienced neurosurgeon.

As Assoc. Prof. Dr. Alican Tahta, I determine the most reliable and long-term treatment option for my patients based on scientific evidence and individual clinical findings.