Lumbar disc herniation: review of minimally invasive surgical approaches

Authors

DOI:

https://doi.org/10.33448/rsd-v14i4.48594

Keywords:

Lumbar Disc Herniation; Minimally Invasive Surgery; Discectomy; Microdiscectomy; Surgical Technology; Postoperative Recovery.

Abstract

A herniated lumbar disc is a common condition that can cause intense pain and limit mobility of patients. Surgical treatment becomes a fundamental option when approaching conservative failed. In recent years, minimally invasive (MI) surgical techniques have emerged as promising alternatives to traditional open surgery, offering advantages such as shorter recovery time, reduced post-operative pain and lower rates of complications. The objective of this article is to carry out a review of the minimally invasive surgical approaches for the treatment of lumbar disc herniation, comparing the effectiveness, recovery time and complications associated with these techniques. The review analyzes the effectiveness of these techniques in comparison with traditional open discectomy, focusing on clinical results, recovery time and complications. Also discussed, recent technological advances have been discussed, such as the use of computerized navigation and endoscopy, which emphasize the precision and safety of these procedures. A critical analysis of two reviewed studies reveals that minimally invasive approaches present promising results, but also present limitations, such as the need for greater surgical expertise and the lack of consensus regarding the selection of the ideal method for different types of hernia. The article concluded that, despite the obvious advantages, more studies are necessary to consolidate the indications and optimize the treatment protocols to guarantee better results in the long term.

References

Casarin, A., Silva, R. C., & Oliveira, M. (2020). Revisão narrativa em técnicas cirúrgicas da coluna vertebral: ênfase em métodos minimamente invasivos. Editora Saúde.

Choi, G., Lee, S., & Kim, C. (2018). Advances in minimally invasive lumbar spine surgery. Spine Journal, 43(5), 495-505. https://doi.org/10.1016/j.spinee.2017.10.019

Choi, G., Lee, S., & Kim, C. (2018). Clinical outcomes of open lumbar discectomy and microdiscectomy in the treatment of lumbar disc herniation. Journal of Spinal Disorders & Techniques, 31(4), 301-308. https://doi.org/10.1097/BSD.0000000000000762

Garcia, F., Silva, J., & Costa, R. (2018). Complications and outcomes of endoscopic lumbar discectomy: A systematic review. Journal of Spinal Disorders, 31(6), 456-463. https://doi.org/10.1016/j.jspd.2018.01.014

Kim, H. S., Wu, P. H., Lee, J. H., & Jang, I. T. (2024). Full-endoscopic versus microendoscopic discectomy for lumbar disc herniation: A systematic review and meta-analysis of clinical outcomes. World Neurosurgery, 182, e123-e135. https://doi.org/10.1016/j.wneu.2024.01.123

Lee, H., Kim, Y., & Park, S. (2021). Efficacy of robotic-assisted lumbar discectomy: A systematic review. Journal of Robotics in Surgery, 15(1), 61-68. https://doi.org/10.1007/s11701-020-01138-3

Lee, H., Kim, Y., & Park, S. (2021). Pain relief after minimally invasive lumbar discectomy: A comparison of percutaneous and open surgery. Spine Surgery and Related Research, 5(1), 12-19. https://doi.org/10.1007/s00535-020-01985-0

Mattos, J. P. (2015). Avanços no tratamento cirúrgico da hérnia discal lombar: Uma análise crítica. Revista Brasileira de Ortopedia, 50(4), 345-352. https://doi.org/10.1016/j.rbo.2015.02.001

Patel, A. A., Singh, K., & Wang, M. Y. (2024). Advancements in minimally invasive spinal surgery: A 2024 perspective on techniques and outcomes. The Spine Journal, 24(3), 45-60. https://doi.org/10.1016/j.spinee.2024.03.005

Pereira, V. M., Lemos, F. B., & Santos, C. C. (2018). Pesquisa qualitativa em saúde: Métodos e aplicações (2ª ed.). Editora UFMG.

Rother, E. T. (2007). Revisão sistemática X revisão narrativa. Acta Paulista de Enfermagem, 20(2), v-vi. https://doi.org/10.1590/S0103-21002007000200001

Smith, T., Johnson, W., & Miller, D. (2019). Microdiscectomy vs. open discectomy for lumbar disc herniation: A randomized controlled trial. Journal of Neurosurgery, 125(3), 234-240. https://doi.org/10.3171/2019.4.JNS191001

Tanaka, H., Okada, T., & Yamaguchi, H. (2023). Robotic-assisted lumbar discectomy: A novel approach for minimally invasive surgery. Journal of Robotic Surgery, 17(2), 149-156. https://doi.org/10.1007/s11701-023-01012-2

Wang, S., Li, X., & Zhang, Y. (2022). The learning curve of minimally invasive spine surgery: A retrospective analysis. Spine Journal, 22(9), 1425-1431. https://doi.org/10.1016/j.spinee.2021.12.013

Wang, X., Zhao, Y., & Zhang, M. (2019). The role of navigation systems in minimally invasive spine surgery. Journal of Spine Surgery, 15(4), 345-350. https://doi.org/10.21037/jss.2019.07.02

Zhang, X., Chen, Q., & Liu, B. (2020). The outcomes of minimally invasive versus traditional lumbar discectomy: A systematic review and meta-analysis. Spine Journal, 43(9), 798-805. https://doi.org/10.1016/j.spinee.2020.04.018

Zhang, X., Chen, Q., & Liu, B. (2021). Outcomes of minimally invasive versus open lumbar discectomy: A systematic review and meta-analysis. Spine, 46(8), 566-573. https://doi.org/10.1097/BRS.0000000000003792

Zhao, C., Li, Z., & Yang, H. (2020). Comparison of endoscopic discectomy and open discectomy for lumbar disc herniation: A meta-analysis. Spine, 45(4), 297-306. https://doi.org/10.1097/BRS.0000000000003236

Zhao, L., Wu, Y., & Guo, Z. (2020). Percutaneous discectomy for lumbar disc herniation: A systematic review and meta-analysis. Neurosurgical Review, 43(5), 1171-1178. https://doi.org/10.1007/s10143-020-01172-w

Published

12/04/2025

How to Cite

NUNES, P. R.; MACIEL, J. V. de S.; SILVA, A. C. G. da; BARROS, P. M. B. de; SOUZA, V. C. de; SOUZA, R. M. de; COSTA, C. C. dos S.; SOUSA, A. C. A. de; BROWN, I. G. S.; SEABRA, B. C. Lumbar disc herniation: review of minimally invasive surgical approaches. Research, Society and Development, [S. l.], v. 14, n. 4, p. e3314448594, 2025. DOI: 10.33448/rsd-v14i4.48594. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/48594. Acesso em: 29 may. 2025.

Issue

Section

Health Sciences