26dkou219 10.3205/26dkou219 urn:nbn:de:0183-26dkou2198 Meeting Abstract von Riegen von Riegen Hanna H

Department of Orthopedics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA

author Greiner Greiner Erica E

Department of Orthopedics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA

author Trunk Trunk Sebastian S

Department of Orthopedics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA Medizinische Fakultät Heidelberg, Ruprecht Karls Universität Heidelberg, Heidelberg, Deutschland

author Pittman Pittman Jason J

Department of Orthopedics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA

author Gandhi Gandhi Sapan S

Department of Orthopedics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA

author German Medical Science GMS Publishing House

Düsseldorf

610 20261020 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0659 219 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026) Abstracts | Moderne operative Wirbelsäulenchirurgie Berlin 20261020 20261023 DKOU26_Abs_2328 TextObjectives and questions: Endoscopic lumbar discectomy is increasingly adopted as a minimally invasive alternative to traditional (i.e.open or tubular) lumbar microdiscectomy. While single-center studies suggest reduced perioperative complications with endoscopic approaches, real-world evidence across broader healthcare systems remains limited. We compared short- and long-term outcomes between endoscopic and traditional lumbar microdiscectomy in a large international database.Material and methods: We queried the TriNetX Global Collaborative Network (>150 healthcare organizations, ~20 countries) for adults (≥18 years) undergoing traditional lumbar microdiscectomy (CPT 63030; excluding CPT 63035) or endoscopic lumbar discectomy (CPT 62380) between 2005–2023. The index event was the first qualifying procedure. Outcomes were analyzed in three time windows: immediate (day 1), short-term (1–90 days), and long-term (20–730 days). To ensure sufficient follow-up, only patients with index procedures up to August 2023 were included in 2-year analyses. Propensity score matching (1:1) was performed across all available demographic, comorbidity, and laboratory variables. Risk differences, ratios, and odds ratios were calculated; patients were censored at their last recorded fact. Sensitivity analyses including later index dates and excluding patients with pre-existing outcomesyielded similar results.Results: After matching, 1,987 patients per cohort were analyzed for 90-day outcomes and 1,263 per cohort for 2-year outcomes. At day 1, dural tears were more frequent after open discectomy (1.0% vs. 0.5%, n.s.), while nerve injury was equal (0.5%). At 90 days, wound complications, urinary tract infections, and readmissions were significantly higher after traditional procedures, whereas persistent pain was more common following endoscopic discectomy (6.5% vs. 3.4%, p<0.001). Neurostimulator implantation was also more frequent after open surgery (0.5% vs. 0%, p=0.002). At 2 years, repeat endoscopic procedures were more common after endoscopic discectomy (2.1% vs. 0.8%, p=0.007), while revision open surgery, laminectomy, and posterior fusion rates were comparable.Discussion and conclusions: In this large real-world cohort, endoscopic discectomy was associated with fewer short-term complications and readmissions compared with traditional microdiscectomy, but also with higher rates of persistent pain and repeat endoscopic procedures at long-term follow-up. These findings complement and partly diverge from single-center reports, highlighting the need for further studies. 0 0 0 0