Endoscopic and microscopic lumbar discectomy: A comparative study of clinical end cost efficacy

The aim. To compare clinical efficacy, recovery time (return to work), and cost-effectiveness of endoscopic versus microsurgical discectomy.

Materials and methods. This retrospective single-center study included 30 patients (15 patients underwent endoscopic discectomy, 15 – microdiscectomy). Assessment parameters included visual analogue scale (VAS) pain scores, Oswestry Disability Index (ODI), minimal clinically important difference (MCID), operative time, duration of analgetic use, length of disability, and treatment costs.

Results. In the early postoperative period and at 1-month follow-up, VAS pain and ODI scores were significantly better in the endoscopy group (p < 0.01). At 3 months, these differences partially persisted. By 12 months, no statistically significant differences were observed. The period of disability was shorter in the endoscopy group (p = 0.033). However, the cost of treatment was significantly higher for endoscopic procedures (p < 0.00001).

Conclusion. Endoscopic discectomy provides an advantage over microdiscectomy for up to 3 months due to less pain and more physical activity, shorter duration of disability, however, in the long term, the results are comparable to microdiscectomy at a higher cost of the endoscopic method for a medical institution, but taking into account the indirect costs associated with disability, the cost of both techniques is comparable. But considering the indirect costs associated with disability, the cost of both methods is comparable.

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