Lumbar discectomy; comparative study of endoscopic VS fenestration operation

ABSTRACT

Discectomy is the standard treatment for lumber disc disease. Fenestration operations involved lot of issue dissection and so the complications Instead the endoscopic discectomy involved less tissue dissection but limited exposure. The objectives of this study were to compare the outcome of endoscopic discectomy and fenestration discectomy interms of relieve from symptoms and complications. Analytic study. Neurosurgical unit Bahawal Victoria hospital Bahawalpur, from Feb 2010 to Aug 2010. Forty cases fulfilling the inclusion criteria were selected. Efficacy of procedure was determined by improvement in Denis pain scale, Macnab's criteria and straight leg raising [SLR] improvement. Forty patients divided in two equal groups. Patients of group A underwent fenestration and Group B endoscopic discectomy 60%of patients had left sciatica while 40% of patients had right sciatica. According to Denis pain scale 10% patients had moderate pain, 30% had severe pain and 60% had constant pain. Straight leg raising test showed, 50% patients had less than 30° SIR, 3O%patients showed SLR of 31 ° to 40 and 2O%patients had SLR more than 40°. MRI findings were disc bulging, protrusion and rupture. Considering SLR, Denis pain scale and Mcnab's criteria of pain control there was no clinical difference found between the two operative procedures except in two patients in group B when open discectomy had to be performed. MED is a safe and effective mode of treatment for low back pain in patients with lumbar disc herniation