Endoscopic or Microscopic Discectomy: Which One Do Neurosurgeons Prefer for Their Own Lumbar Disc Surgery?

Abstract

Aim: To examine the factors influencing neurosurgeons? preferences between microscopic discectomy (MD) and endoscopic discectomy (ED) for the treatment of lumbar disc herniation (LDH) in Türkiye.

Material and methods: A cross-sectional survey was administered to 229 active neurosurgeons in Türkiye. The 23-item questionnaire assessed various factors influencing the preference for ED or MD, including training, surgical experience, demographic characteristics, and institutional factors. Data analysis was performed via ANOVA, multivariate logistic regression, chi-square tests, t tests, and descriptive statistics. A thematic analysis was conducted on the open-ended responses.

Results: The results revealed that while traditional MD remained the preferred technique among older and more experienced neurosurgeons, 62.9% of surgeons with endoscopic training favored ED. Surgical preferences are significantly influenced by handson experience and institutional support for endoscopic procedures. Although younger surgeons preferred ED, MD was favored in complex and emergency situations (p < 0.05).

Conclusion: Younger surgeons increasingly opt for ED because of their familiarity with minimally invasive techniques, although MD remains the predominant approach among more experienced surgeons. Surgical decisions are heavily influenced by institutional support and practical experience. Continuous education and support for endoscopic methods will be essential for enhancing patient outcomes and integrating new technologies into clinical practice as surgical practices evolve.