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Infographic. Endoscopic versus open discectomy for sciatica? Which is more cost-effective?
  1. Pravesh Shankar Gadjradj
  2. on behalf of the PTED-study group
    1. Department of Neurological Surgery, Brain and Spine Center, New York, New York, USA
    1. Correspondence to Dr Pravesh Shankar Gadjradj, Department of Neurological Surgery, Brain and Spine Center, New York, NY 10021, USA; p.gadjradj{at}

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    Sciatica caused by lumbar disc herniation is a frequently encountered disease in the general population.1 Even though the natural course is favourable, due to its high prevalence, lumbar discectomy is a frequently performed procedure resulting in high costs for society. Conventional open microdiscectomy is seen as the standard procedure to treat sciatica. Surgical innovation and the development of endoscopes have led to the development of endoscopic techniques such as percutaneous transforaminal endoscopic discectomy (PTED).2 These techniques were developed with the intention of reducing surgical invasiveness and thus improving patient outcomes. A recent meta-analysis showed moderate-level evidence of no differences in leg pain reduction between PTED and microdiscectomy. Furthermore, it showed …

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    • Collaborators The PTED Study group consists of Dr Pravesh Gadjradj, Dr Paul Depauw, Dr Pieter Schutte, Dr Arnold Vreeling, Dr Job van Susante, Dr Sidney Rubinstein, Dr Biswadjiet Harhangi, Dr. Wilco Peul and Professor Dr Maurits van Tulder. Dr Hanna Broulikova and Dr Hanneke van Dongen were involved in the economic evaluation.

    • Contributors PSG developed this work as a member of the PTED Study group.

    • Funding This study was funded by ZonMw, the Netherlands Organization for Health Research and Development (project number 837004013).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.