Patients often ask me about the endoscopic discectomy success rate, and how it compares with other endoscopic spine procedures. This blog explains how results can vary from one person to the next. If you are considering endoscopic discectomy surgery or another form of minimally invasive spine surgery, I would recommend discussing the following points during your consultation.
NICE reviewed the evidence on transforaminal endoscopic surgery for lumbar disc herniation. Across the studies, patients had a median improvement of 88% in leg pain, and a median of 90% returned to work. However, these figures come from groups of patients, and your own outcome will depend on your diagnosis, the procedure and your general health.
Key Takeaways
- Success can be measured in many ways depending on your diagnosis: pain relief, a longer walking distance, returning to work or not needing another operation.
- The strongest evidence is for herniated discs.
- Age, smoking, diabetes, how long you have had symptoms and the number of levels treated all affect your outcome.
- Operations that involve stabilisation take longer to recover from.
- You will get a much more accurate picture once your scans and symptoms have been reviewed.
How Does the Success Rate Differ Between Spine Conditions?
There is no single success figure that applies to every endoscopic procedure. Patients have different goals from their surgery. Some want to reduce their leg pain, while others want to be able to walk to the shops without stopping. The result also differs based on your diagnosis.
Endoscopic Discectomy for a Herniated Disc
The endoscopic discectomy success rate has the most evidence behind it. A meta-analysis published in the European Spine Journal in 2016 found that 93.21% of patients were satisfied after endoscopic discectomy, compared with 86.57% after open discectomy. NICE found a reoperation rate of 6.8% for transforaminal endoscopic surgery and 4.7% for open microdiscectomy, a difference that was not statistically significant.
Lumbar Spinal Stenosis
This involves decompressing the nerves to relieve pressure caused by narrowing of the spinal canal. Patients who have leg pain from the narrowing often improve their walking distance. However, if they also have back pain from several worn discs, the result can be less predictable.
Spinal Instability or Deformity
Some patients with spondylolisthesis or scoliosis need stabilisation. The outcome depends on how well the bones heal and how well aligned the spine is, and this can take months to judge.
| Condition | How success is usually judged | How predictable the result is |
|---|---|---|
| Herniated disc | Relief of leg pain, return to work | Most evidence; generally good results |
| Lumbar spinal stenosis | Longer walking distance, less leg pain | Good for leg pain; less predictable for back pain |
| Instability or deformity | Bone healing and spinal alignment | Takes months to judge; longer recovery |
Which 6 Factors Affect the Endoscopic Discectomy Success Rate?
Two patients with the same MRI can have a very different endoscopic discectomy success rate. Factors that can influence this include:
- Diagnosis: your symptoms must match the findings on your scan and examination.
- Duration of symptoms: if a nerve has been under pressure for a long time, it may take longer to settle.
- Age: this affects how well your bones heal, particularly if a fusion is needed.
- General health: smoking, diabetes and excess weight can all slow healing.
- Number of levels: surgery on one level usually behaves more predictably.
- Surgeon experience: there is a learning curve with endoscopic surgery, and it is important to match the right technique to the right patient.
If you are unsure what applies to you, please make an appointment and we can go through your scans together.
What Does Recovery After Endoscopic Discectomy Look Like?
Recovery is one of the ways we judge how successful your surgery has been, and it plays a big part in your personal endoscopic discectomy success rate.
The First Few Weeks
Because the incisions are smaller and less muscle is disturbed, you will often have a shorter hospital stay. I encourage early mobilisation, but please avoid heavy lifting and prolonged bending.
Symptoms to Report Straight Away
- A raised temperature or discharge from the wound
- New weakness in a leg or foot
- Loss of bladder or bowel control
- A sudden increase in pain
After the First Few Weeks
Physiotherapy will help build your core strength. You may be able to return to a desk-based job within weeks of a discectomy. If you have a physical job or have had a fusion, this can take longer. Stop smoking, keep your blood sugar stable and attend all of your follow-up appointments.
At your appointment, I will discuss with you when you can expect to recover from your procedure.
Understanding the Endoscopic Discectomy Success Rate Before You Decide
Ask your surgeon about the outcomes for your diagnosis. During your consultation, you should be told how much benefit you can expect, the chance of the problem coming back, the alternative treatments and the likely recovery time. For an overview of the procedure and the conditions it treats, see our page on endoscopic spine surgery in Mumbai, which also explains the endoscopic spine surgery success rate for each condition.
If you would like a second opinion before committing, I am happy to assess your case and advise you on the safest option. Please get in touch to make an appointment with Dr Akhil Tawari.
Frequently Asked Questions
What is a good endoscopic discectomy success rate?
This will depend on your diagnosis. For lumbar disc herniations, NICE reported that a median of 85% of patients had satisfactory outcomes in non-controlled studies. The success rate will differ for stenosis and instability, so it is more important to know your diagnosis.
Is endoscopic discectomy as effective as open surgery?
Studies have shown that for selected disc herniations the outcomes are comparable. The 2016 meta-analysis also showed less blood loss and shorter hospital stays. Open surgery or fusion can be better for more complex problems.
How long will I be recovering?
Many patients are able to return to light activity within a few weeks of their discectomy. If you have had a fusion or deformity surgery, this will usually take several months.
Can my symptoms come back?
Yes. NICE reported a median reoperation rate of 7% in non-controlled studies. Good rehabilitation and a healthy lifestyle can help reduce this risk.
Am I a suitable candidate?
This will depend on your scans, symptoms, response to non-operative treatment and general health. I will be able to tell you once I have assessed you clinically.