| Background: Open discectomy is a conventional surgical treatment of lumbar disc herniation but there has been a trend towards minimally invasive procedures.Micro-endoscopic discectomy is a well-established minimally invasive procedure performed for the surgical management of lumbar disc herniation.It is an emerging procedure and widely accepted in recent years.The reported success rate of micro-endoscopic discectomy is about approximately 90%.The comparative studies on outcome of these two procedures in single setting have been lacking,therefore we designed a study to fulfill this knowledge gap.Objectives: To identify the functional outcomes in terms of ODI score,VAS score in terms of intraoperative blood loss,intraoperative time and use of anesthesia and morbidity in terms of total hospital stays between micro-endoscopic and open discectomy groups.Methods: A randomized prospective study was designed.All the patients with clinical signs and symptoms of lumbar disc herniation with two weeks of failed conservative treatment plus MRI or CT scan findings suggestive of lumbar disc herniation were included.Time-frame based sampling technique was adopted,all the patients presented during the time-frame from February2018 to April 2020 at Hebei 3rd orthopedic provincial hospital,department of orthopedic surgery in spinal Unit,situated in Hebei Province,Shijiazhuang city,China were included in the study.These patients were randomized to surgical management either with micro-endoscopic and or with open discectomy.The preoperative and post-operative ODI and VAS score,duration of total hospital stays,intraoperative blood loss and operation time were compared between these two groups and their statistical significance was assessed.Results: A total of 90 patients were enrolled in the study.Forty-five underwent micro-endoscopic(25 females and 20 males)and 45 underwent open(20 males and 25 females)lumbar discectomy.Surgical and anesthesia time were significantly shorter,blood loss and hospital stay were significantly reduced in patients having micro-endoscopic discectomy(P<0.05).The ODI score improvement in both groups was statistically significant(P<0.05)at post-operative 1st day.But at the end of 6th week and 6th month postoperative,there was no statistical significance(P>0.05).Although the VAS and ODI scores had improved significantly postoperatively in both groups,the micro-endoscopic group was significantly superior with less hospital stay,shorter operation time,and less blood loss(P < 0.05).Conclusion: Both micro-endoscopic and open lumbar discectomy were equally effective in relieving radicular pain.In addition,the micro-endoscopic discectomy was superior in relation to total hospital stay,earlier return to work and anesthetic exposure,blood loss,and intraoperative time when compared with open lumbar discectomy.Micro-endoscopic discectomy was safe and effective alternative to conventional open lumbar discectomy for patients with lumbar disc herniation. |
