{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:15:05Z","timestamp":1793297705626,"version":"4.5.0"},"reference-count":53,"publisher":"The Korean Spinal Neurosurgery Society","issue":"1","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Patient-Centered Clinical Research Coordinating Center"},{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["RS-2025-02216840"],"award-info":[{"award-number":["RS-2025-02216840"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-neurospine.org"],"crossmark-restriction":true},"short-container-title":["Neurospine"],"published-print":{"date-parts":[[2026,1,31]]},"abstract":"<jats:p>Objective: This systematic review and meta-analysis aimed to compare endoscopic discectomy (ED) with microdiscectomy (MD) for lumbar disc herniation, evaluating patient-reported outcomes, perioperative parameters, and complications to determine if ED could replace MD as the gold standard.Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, we searched PubMed, Embase, Scopus, and Web of Science (January 2000\u2013June 2025) for randomized controlled trials (RCTs) and prospective cohort studies comparing MD with ED subtypes (transforaminal endoscopic lumbar discectomy [TELD], interlaminar endoscopic lumbar discectomy [IELD], and unilateral biportal endoscopy [UBE]). Outcomes included Oswestry Disability Index (ODI), visual analogue scale (VAS) for pain, operative time, hospital stay, complications, and recurrence. Pooled mean differences and odds ratios (ORs) were calculated using random-effects models, with subgroup analyses by ED subtype. Risk of bias was assessed using RoB 2.0 and ROBINS-I tools.Results: Seventeen studies (9 RCTs, 8 cohorts; n=3,115) were included. ED significantly reduced hospital stay (mean difference, -2.43 days; 95% CI, -3.62 to -1.23; p&lt;0.05) and showed greater short-term ODI improvement (mean difference, 2.13; 95% CI, 0.58\u20133.67). No differences were observed in operative time, long-term ODI, or VAS scores. ED had lower wound complications but a higher recurrence risk with TELD (OR, ~2.0). High heterogeneity (I\u00b2&gt;95%) and limited long-term data (&gt;2 years) were noted.Conclusion: ED offers perioperative advantages and comparable efficacy but does not surpass MD due to TELD\u2019s increased recurrence risk. IELD and UBE are promising alternatives, but MD remains the benchmark. Long-term RCTs are needed.<\/jats:p>","DOI":"10.14245\/ns.2551450.725","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T01:18:48Z","timestamp":1769735928000},"page":"61-79","update-policy":"https:\/\/doi.org\/10.14245\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Beyond the Microscope: Is Endoscopic Discectomy the Next Gold Standard for Lumbar Disc Herniation?"],"prefix":"10.14245","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6804-6644","authenticated-orcid":true,"given":"Borriwat","family":"Santipas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5086-0875","authenticated-orcid":true,"given":"Jin Sung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4332-5038","authenticated-orcid":true,"given":"Korawish","family":"Mekariya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1887-5430","authenticated-orcid":true,"given":"John Y.S.","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7511-2486","authenticated-orcid":true,"given":"Samuel K.","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5355","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-014-3803-7"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012938"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-018-4247-6"},{"key":"ref4","first-page":"331","volume-title":"Technical adjuncts in neurosurgery","author":"Yasargil","year":"1977"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2022.06.023"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-023-07622-7"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2346190.095"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2025.02.006"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1177\/2192568220948814"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-023-08116-2"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-025-02856-2"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2550398.199"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1411"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-016-4885-6"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.08.165"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.05.085"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.36076\/ppj\/2019.22.295"},{"key":"ref21","first-page":"27","volume-title":"Immediate and long-term results of percutaneous full-endoscopic and microsurgical lumbar discectomy: prospective cohort study","author":"Kravtsov","year":"2019"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.21182\/jmisst.2022.00570"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-065846"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2022.09.003"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2346674.337"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.22141\/1608-1706.4.25.2024.983"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.4103\/isj.isj_25_23"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1186\/s41983-024-00788-x"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620x.107b5.bjj-2024-1560.r1"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.14245\/kjs.2012.9.3.215"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.14444\/7010"},{"key":"ref32","first-page":"931","volume-title":"Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study","author":"Ruetten","year":"2008"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1177\/21925682231220042"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.08.236"},{"key":"ref35","first-page":"538","volume-title":"Percutaneous transforaminal endoscopic discectomy versus open microdiscectomy for lumbar disc herniation: a systematic review and meta-analysis","author":"Gadjradj","year":"2021"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-018-0868-0"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1177\/21925682221120530"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.1107883"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.3171\/2019.6.spine19532"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.03.128"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000030612"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.14444\/8545"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2023.01.009"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.01.086"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2448346.173"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.02.003"},{"key":"ref47","first-page":"695","volume-title":"Comparison of clinical outcomes and muscle invasiveness between unilateral biportal endoscopic discectomy and percutaneous endoscopic interlaminar discectomy for lumbar disc herniation at L5\/S1 Level","author":"Wang","year":"2023"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2016.04.004"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2021-104808"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.4103\/singaporemedj.smj-2024-070"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.21182\/jmisst.2024.01578"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1177\/21925682241289901"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-022-03052-1"}],"container-title":["Neurospine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-neurospine.org\/upload\/pdf\/ns-2551450-725.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-neurospine.org\/journal\/view.php?doi=10.14245\/ns.2551450.725","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-neurospine.org\/upload\/pdf\/ns-2551450-725.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T04:51:52Z","timestamp":1769748712000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-neurospine.org\/journal\/view.php?doi=10.14245\/ns.2551450.725"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,31]]},"references-count":53,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.14245\/ns.2551450.725","relation":{},"ISSN":["2586-6583","2586-6591"],"issn-type":[{"value":"2586-6583","type":"print"},{"value":"2586-6591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,31]]},"assertion":[{"value":"2025-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-31","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-31","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}