Our Summary

This study looked at a new, less invasive surgery for herniated discs in the lower back called Full-endoscopic lumbar discectomy (FELD). They wanted to find out if FELD is better than traditional methods. They looked at many different studies, checking the quality of each one. They focused on four things: side effects, how long the surgery took, how long patients had to stay in bed and in hospital after the surgery, and how well the patients were doing after the surgery.

They found that FELD did have some advantages. It helped with pain relief in the short term (within 6 months after the surgery) and it helped patients get out of bed and start moving faster. It also had about the same risks as traditional methods for the disc slipping again, needing another surgery, and other complications. But, there was a lot of difference in the information they found and not many studies that looked forward in time.

The study concluded that more well-designed studies are needed that look forward in time and also consider the costs of the surgery. They want to find out if FELD really is the best option for this type of surgery. They think we’re getting closer to an answer, but there’s still a lot more to find out.

FAQs

  1. What is Full-endoscopic lumbar discectomy (FELD) and how does it differ from traditional methods of surgery for herniated discs?
  2. What advantages and risks were identified in the study related to FELD?
  3. Why is there a need for more studies on FELD according to the findings of this study?

Doctor’s Tip

A doctor might tell a patient considering microdiscectomy that Full-endoscopic lumbar discectomy (FELD) is a newer, less invasive option for herniated discs in the lower back. It can provide pain relief in the short term and help patients recover faster. However, more research is needed to determine if FELD is truly the best option in the long term. It is important to discuss the risks and benefits of the surgery with your doctor before making a decision.

Suitable For

Typically, patients recommended for microdiscectomy are those with a herniated disc in the lower back that is causing severe pain, weakness, and/or numbness in the legs. These symptoms are often due to pressure on the spinal nerves from the herniated disc. Patients who have not found relief from conservative treatments such as physical therapy, medications, and injections may be good candidates for microdiscectomy. It is important for patients to discuss their specific symptoms and medical history with their healthcare provider to determine if microdiscectomy is the best option for them.

Timeline

Before microdiscectomy:

  1. Patient experiences back pain, leg pain, numbness, and/or weakness due to a herniated disc in the lower back.
  2. Patient undergoes diagnostic tests such as MRI or CT scan to confirm the diagnosis.
  3. Patient may undergo conservative treatments such as physical therapy, medications, and epidural injections to manage symptoms.
  4. If conservative treatments are ineffective, patient and surgeon discuss the option of microdiscectomy as a surgical treatment.

After microdiscectomy:

  1. Patient undergoes microdiscectomy surgery to remove the herniated portion of the disc.
  2. Patient may experience immediate relief from leg pain and other symptoms after surgery.
  3. Patient is typically able to walk and move around shortly after surgery.
  4. Patient may experience some post-operative pain and discomfort, which can be managed with medications.
  5. Patient may need to stay in the hospital for a short period of time for observation.
  6. Patient may need to follow a rehabilitation program to strengthen the back muscles and prevent future disc herniation.
  7. Patient’s symptoms continue to improve over time as the back heals and the nerve irritation resolves.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with microdiscectomy surgery?
  2. How long is the recovery process after microdiscectomy surgery?
  3. What type of post-operative care and physical therapy will be required?
  4. What are the success rates of microdiscectomy surgery in terms of pain relief and overall improvement in symptoms?
  5. Are there any alternative treatment options to consider before undergoing microdiscectomy surgery?
  6. How many microdiscectomy surgeries have you performed and what is your success rate?
  7. What is the expected outcome in terms of returning to normal activities and work after microdiscectomy surgery?
  8. Will I need to undergo any additional imaging tests or follow-up appointments after the surgery?
  9. What are the long-term implications of undergoing microdiscectomy surgery, especially in terms of future disc herniation or complications?
  10. Are there any specific lifestyle changes or precautions I should take after undergoing microdiscectomy surgery to prevent future issues with my lower back?

Reference

Authors: Latka K, Kozlowska K, Domisiewicz K, Klepinowski T, Latka D. Journal: Spine J. 2025 Feb 28:S1529-9430(25)00101-9. doi: 10.1016/j.spinee.2025.02.006. Online ahead of print. PMID: 40024345