• Mehmet Osman Akçakaya, Ali Güven Yörükoğlu, Aydın Aydoseli, Yavuz Aras, Pulat Akın Sabancı, Muhittin Emre Altunrende, Müge Dolgun, Burcu Göker, Fahir Şencan, Achmet Ali, and Altay Sencer.
• Department of Neurosurgery, Liv Hospital, Istanbul, Turkey. Electronic address: moakcakaya@gmail.com.
• Clin Neurol Neurosurg. 2016 Jun 1; 145: 74-8.

ObjectiveThe aim of this study is to make a comparison between fully endoscopic lumbar discectomy (FELD) and conventional microdiscectomy (MD) by using pre- and postoperative serum creatine phosphokinase (CPK) levels in correlation with postoperative low-back pain.MethodsFortyfive consecutive patients who underwent surgery for lumbar disc herniation were allocated into three groups with 15 patients on each: (1) FELD with interlaminar approach (IL), (2) FELD with transforaminal approach (TF), (3) Conventional MD. Serum CPK levels pre- and 1, 6, 12 and 24h postoperatively, patients' body mass index (BMI), operation duration and hospital stays were recorded. The low-back pain pre- and postoperatively was assessed with the use of the 100mm visual analog scale (VAS) and the "Oswestry Disability Index" (ODI).ResultsThere were 16 female (35.5%) and 29 male (64.5%) patients with a mean age of 44.1 years. CPK levels at 6th, 12th and 24th hours postoperatively were found significantly lower in TF and IL groups compared to MD group (p<0.004). Mean operation duration was significantly shorter in MD group (p: 0.014). There was a significant decrease in both the VAS and ODI scores after the surgery in all patient groups (p<0.001). Postoperative VAS scores were found significantly higher in MD group (p: 0.04).ConclusionMinimal invasive nature of FELD procedures compared to the MD was substantiated by serum CPK levels in this study. To draw definitive conclusions regarding pain relief, larger patient samples should be evaluated, although postoperative VAS scores were found in favor of FELD.Copyright © 2016 Elsevier B.V. All rights reserved.

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