[A comparative analysis of the effectiveness and potential of endoscopic and microsurgical resection of disc herniations in the lumbosacral spine].

The issue of advantage of endoscopic treatment of spinal disc herniations is debatable. Throughout the development, endoscopic technologies have been compared to microsurgical methods. The two-year experience of applying endoscopic methods was analyzed. The study included 183 patients. The effectiveness of the performed treatment was evaluated according to the MacNab scale of surgical treatment outcomes. Good and excellent results were obtained in 170 cases, which amounted to 92.9%. This cure rate was compared to the similar rate for good and excellent results of the microsurgical treatment method derived from the literature data. The article by American authors who conducted a multicenter study (Lumbar microdiscectomy: a historical perspective and current technical considerations. Koebbe C.J., Maroon J.C., Abla A., El-Kadi H., Bost J. Neurosurg Focus 2002 Aug 15; 13(2): E3) was used. On the basis of this study, the data on higher effectiveness of endoscopic discectomy compared to the microsurgical technique were obtained. The technical capabilities of the endoscopic method for removing spinal disc herniations in comparison to minimally invasive microsurgical techniques were carefully analyzed. It was noted that there were no significant instrumental limitations for using endoscopic techniques, while angled optics and excellent color rendition enable better visualization of the surgical wound structures and more efficient use of the approach space. Given that the technical characteristics and capabilities of this method are not inferior to those of the microsurgical technique, the former technology can be used instead of the standard technique for removing intervertebral disc herniations. Furthermore, the technical capabilities of the method allow performing wide decompression of the neural structures during surgery, which can be used to treat spinal stenoses.