LAUSR

BACKGROUND Sciatica caused by lumbar disc herniation is a frequently encountered disease in the general population. 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). These techniques were developed with the intention of reducing surgical invasiveness and thus improving patient outcomes. A recent metaanalysis showed moderatelevel evidence of no differences in leg pain reduction between PTED and microdiscectomy. Furthermore, it showed that no economic evaluations have been conducted. Therefore, the PTED Study was conceived and conducted. This randomised controlled trial demonstrated noninferiority of PTED to microdiscectomy in leg pain reduction. The question remains: when PTED is noninferior to microdiscectomy, which procedure is more costeffective?