Comparison of Microdiscectomy versus Conventional Discectomy for Single Level Lumbar Disc Herniation

Open Access

Abstract

Background: Lumbar disc herniation is a common spinal disorder causing radicular pain, neurological deficits, and functional disability. Surgical intervention is indicated when conservative management fails. Microdiscectomy and conventional discectomy are widely practiced surgical techniques, but comparative evidence regarding their effectiveness, recovery, and complications remains limited, particularly in the Bangladeshi population. Aim of the Study: To compare microdiscectomy and conventional discectomy in terms of perioperative parameters, pain relief, functional outcomes, and complications in patients with single-level lumbar disc herniation. Methods & Materials: A prospective comparative study was conducted on 120 patients (60 microdiscectomy, 60 conventional discectomy). Outcomes included operative time, blood loss, incision length, VAS pain scores, ODI, postoperative recovery, complications, and Modified Macnab criteria at six months. Results: Microdiscectomy demonstrated significantly shorter operative time (72.4 ± 15.6 vs 84.3 ± 17.1 min; p=0.001), reduced intraoperative blood loss (58.6 ± 22.4 vs 112.8 ± 34.6 ml; p<0.001), and smaller incision length (2.5 ± 0.6 vs 5.1 ± 0.9 cm; p<0.001) compared with conventional discectomy. Postoperative recovery was faster with microdiscectomy, including earlier mobilization (12.6 ± 5.4 vs 20.7 ± 6.8 h; p<0.001), shorter hospital stay (2.1 ± 0.9 vs 4.3 ± 1.4 days; p<0.001), and quicker return to work (4.8 ± 1.9 vs 7.3 ± 2.6 weeks; p<0.001). Improvement in VAS leg pain (6.5 ± 1.1 vs 5.7 ± 1.3; p=0.001), VAS back pain (4.9 ± 1.2 vs 4.2 ± 1.4; p=0.008), and ODI (44.6 ± 10.1 vs 40.4 ± 9.7; p=0.01) was significantly greater in the microdiscectomy group. Overall successful outcomes (excellent + good) were higher in the microdiscectomy group (86.7% vs 76.7%). Conclusion: Microdiscectomy is associated with superior perioperative safety, reduced surgical trauma, faster recovery, and better pain and functional outcomes compared with conventional discectomy, supporting its preference in appropriately selected patients with single-level lumbar disc herniation.