Microendoscopic discectomy is the blending of percutaneous procedures and the best of microdiscectomy. It allows for a minimum of tissue injury while optimizing the visualization. The 1.5cm incision disrupts minimal muscle. Direct observation of the nerve root maximizes the success of the procedure. The surgical outcomes, in terms of pain relief, match microdiscectomy. However, due to less tissue trauma, the return to activities and work is accelerated. Early reports indicate a mean return to work time of 14 days, as compared to 4-6 weeks for non-workers’ compensation pathology. Work related disc herniations returned to employment in approximately 58 days.

In appropriately selected patients, 90-95% of herniated discs are improved by surgery. Half of these patients have excellent relief of their symptoms. The remaining patients have significant (80%) improvement of their leg pain, but continue with a fair amount of back pain. This is partially due to the destabilization of the disc by the discectomy and the loss of disc height. Disc herniation has a 6% recurrence rate. The 5-10% of patients that do not improve usually have problems with epidural fibrosis, and to a lesser degree, have residual disc pathology. As you can appreciate, improvement in outcome with surgery is found by lessening scar tissue (epidural fibrosis) and by enhanced visualization of the nerve root compression.