Full-Endoscopic Lumbar Disc Surgery for Sciatica is not only non-inferior in leg pain reduction compared to Microdiscectomy, but also dominant in Cost-effectiveness. Time for a paradigm shift?
In a double-publication, the first results of the PTED-study were published in the British Medical Journal and the British Journal of Sports Medicine.
The effectiveness paper concluded that Full-endoscopic discectomy was non-inferior to open microdiscectomy in reduction of leg pain. Full-endoscopic discectomy resulted in more favourable results for self-reported leg pain, back pain, functional status, quality of life, and recovery. These differences, however, were small and may not reach clinical relevance. Full-endoscopic discectomy can be considered as an effective alternative to open microdiscectomy in treating sciatica.
The first results are published here.
The cost-effectiveness paper concluded that acceptability curves indicated that the probability of Full-endoscopic discectomy being less costly and more effective (ie, dominant) compared with open microdiscectomy was 99.4% for leg pain and 99.2% for QALYs. Therefore, our results suggest that Full-endoscopic discectomy is more cost-effective from the societal perspective compared with open microdiscectomy for patients with sciatica. You can read this part here.
All hospitals involved in this study used the MaxMoreSpine PTED endoscopic system.