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Full-endoscopic lumbar disc surgery: the new gold standard? (PhD Academy Award)
  1. Pravesh Shankar Gadjradj
  1. Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian Hospital, New York, NY, USA
  1. Correspondence to Dr Pravesh Shankar Gadjradj, Erasmus MC, Rotterdam 10021, The Netherlands; p.gadjradj{at}

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What did I do?

The main aim of my PhD research was to provide high-quality evidence regarding the cost-effectiveness of percutaneous transforaminal endoscopic discectomy (PTED) compared with conventional open microdiscectomy in patients with sciatica.

Why did I do it?

Sciatica is a common healthcare problem and leads to high costs both at the individual and at the societal level. The current standard procedure to treat sciatica caused by lumbar disc herniation is microdiscectomy.1 Microdiscectomy is a relatively old procedure during which the disc herniation can be removed safely through a dorsal approach. Another relatively new procedure is PTED during which the disc herniation is removed through a smaller incision at the lateral side from the spine (figure 1).2 Aside from the difference in incision size, PTED is performed under local anaesthesia, allows outpatient surgery, and does not require detachment of the back muscles or destruction of bony anatomy. PTED, however, seems to be more challenging to be performed and requires patients to be exposed to a higher dose of radiation due to the extensive use of intraoperative fluoroscopy.

Figure 1

An overview of the surgical approach …

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  • Contributors PSG conducted his PhD-research as part of the PTED-study group.

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

  • Disclaimer ZonMw did not participate in the study design, conduct of the study, in the collection, analysis, and interpretation of the data, nor in the preparation, review or approval of the manuscript.

  • Competing interests None declared.

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