Abstract
Open (micro) discectomie is a routine treatment for patients with a lumbar disc hernia and incapacitating sciatica, resistant to conservative treatment. Alternatively, the full-endoscopic discectomy has been increasingly performed over the past years.
While the surgical instrumentation for this approach has improved and the necessary specialized training is widely available, the technique remains challenging for the surgeon and the assumed/theoretical advantage regarding patient morbidity is still unproven.
When compared to open (micro) discectomie, the existing literature fails to attribute significant decreases in length of hospital stay or complication rates to the full-endoscopic approach, therefore making the cost-benefit analysis uninteresting due to the higher associated cost.
The structural lack of financing of Belgian hospitals leads to intrinsic budgetary limitations which are emphasized if the hospitals have to carry the extra costs related to endoscopic disc surgery themselves.