European Journal of Molecular & Clinical Medicine

Lumbar prolapse of intervertebral disc (PIVD) is seen in over 1% of adults with the most incidence between the 3rd to 5th decades of life. It appears to be more prevalent in the male population and predominantly affects the L4-L5 and L5-S1 levels. Over the years several surgical techniques have been developed for its management but the best technique is still debatable.
Aims: This study aims to compare both immediate and long-term functional outcome following minimally invasive spine surgery (MISS) and open discectomies for Lumbar prolapse.
Settings and Design: It is a non-randomised controlled study.
Methods and Material: The patients, diagnosed with lumbar disc prolapse, were taken for the surgery of choice following an initial assessment. The outcome is assessed in the immediate post-operative period using VAS and ODI and long-term functional outcome using Modified macnab criteria between 12 and 18 months post-surgery.
Statistical analysis used: The IBM SPSS software was used to study the correlation. One-tailed ANOVA with CI of 95% was conducted for VAS score and ODI score while Mann-Whitney U test was done on the Modified Macnab Criteria.
Results: This study was conducted on 103 subjects with 56.3% undergoing open discectomies while 43.7% underwent minimally invasive discectomies. 73 subjects were operated on the L4-L5 level and 30 on the L5-S1 level. The study revealed that the operative duration of MISS is significantly more than that of open procedure. The VAS score for the MISS procedure had a mean change of 3.067 in the immediate postoperative period versus the mean reduction of 2.603 for open procedure. The ODI of MISS has decreased from 44.27 to 13.73 and that of Open procedure has decreased from 43.19 to 17.48. The long-term outcome at 12-18 months after surgery was excellent for 75.5% of MISS patients but only 25.9% open discectomy cases
Conclusions: The MISS procedure did not produce a strongly clinical outcome compared to open discectomies in the immediate after surgery but the functional outcome of MISS procedure on the long-term was greater than that of the conventional method

Objectives: To evaluate the results of micro-endoscopic discectomy and open discectomy in lumbar disc prolapse.
Methods: This study is a prospectively conducted study of 30 patients operated by a single surgeon with both modalities. The first modality is endoscopic discectomy using METRx system (Medtronic, Sofamor-Danek, Memphis, TN) using 22mm port and the second is open method of discectomy for lumbar disc herniation.
Results: The results were evaluated using ODI (Oswestry Disability Index) and VAS (visual analogue scale 0-10) for back pain and leg pain. Patients were followed up at an interval of 1 week, 2 week, 1 month, 6 months and 12 months post-operatively.
Conclusion: By limiting the tissue manipulation via small incisions and minimal muscle dissection, MED has reported to have better perioperative outcomes, including shorter hospital stay, less blood loss, less pain medicine requirement, decreased surgical site infection rate, quicker return to activities and Early discharge rate than open method. Although MED have some advantages over the open techniques in the perioperative factors, both the techniques are effective and provide similar pain relief and functional outcomes at the end of 2 years.

Lumbar intervertebral disc herniation is one of the main causes of low back ache and sciatica,
which might incapacitate a person. There are many techniques available for treating lumbar
disc herniation. But conventional standard open discectomy is still the most acceptable
method today. Numerous retrospective and some prospective reviews of open disc surgeries
are available. These studies have reported excellent results in 46 to 97% of the patients.30
Cases of lumbar disc herniation which have been treated by open discectomy, satisfying
inclusion and exclusion criterias, admitted in Hospital were studied. Preoperative and
postoperative scores were taken and the rate of improvement in terms of percentage was
calculated using Japanese Orthopaedic Association Low Backache score.In our study we
achieved 90% good results, 6.67% fair results, poor outcome of 3.33%, and the results were
comparable to other studies.There are many techniques for treatment of lumbar disc
herniation but conventional standard open discectomy is still the most acceptable method for
the Indian scenario