ИСТИНА

Technological progress during past 15 years made us possible to use really minimally invasive techniques in treatment of lumbar disc herniations. But minimizing operative trauma has it's downfalls. Portal endoscopic methods are well-known for more than 10 years, but it's really difficult to compare them and measure their effectiveness. During past 10 years we thoroughly accumulated experience in this technology and have compared different endoscopic methods and microsurgical ones. Material and methods. During past 10 years we operatied 2273 patients. 1510 of them were operated using endoscopic portal discectomy. Comparing group that was treated using microsurgical discectomy consisted of 763 patients. We measured 3 main aspects of endoscopic METHODS: 1) clinical effectiveness (using MacNab, VAS and EuroQual-5D scales before, after and 6 months after operation), 2) reoccurrence rate and 3) technical usability and capabilities of methods. Results. According to our data after the operation patients patients had statistically significant difference in quality of life in favor for endoscopic methods. But 6 months this difference is becoming insignificant. Thus we assumed that this technologies don’t have a long-term difference. Reoccurrence was also insignificant. The most interesting fact was that technical capabilities of methods really differ. Conclusion.We conclude that endoscopic and microsurgical methods are almost the same in regard of clinical recovery of patients, but technical differences make this methods more preferable in some cases. Thus we made a clinical algorithm for decision making in choosing the best method.