TO COMPARE THE CLINICAL OUTCOMES IN TERMS OF PAIN RELIEF AND FUNCTIONAL OUTCOMES BETWEEN MICROLUMBAR DISCECTOMY AND OPEN FENESTRATION WITH DISCECTOMY.

Introduction: Human beings are suffering from backache and leg pain since beginning of history. The origin of disc related sciatica with its pathology and clinical neurological findings were recognized only in the 20th century. the lumbar disc surgery and intra discal therapy are recent developments. Aims and objectives: Our aim of study is to know if micro surgery gives better results than gold standard open technique in terms of pain relief, functional outcome to call it cost effective. Materials and methods: Sample has two groups with 20 patients each who underwent micro lumbar discectomy and open fenestration discectomy. Patients were selected in each group who presented to out-patients clinic in two hospitals at same period of time. Data was recorded in study proforma and vas score and JOA scores were used. Statistical analysis was done using student t test (two tailed, independent). Results: Our study shows improvement rate of 63+12.5 % in MLD group and 57+10.2 % at the end of 1 year. it shows better results in MLD group which is statistically strongly significant in post-operative period, 1 month, 6 months and no difference at 1 year and 2 years. Discussion: Most studies show that surgically treated patients do better than non-operative patients initially; the difference between the two treatments diminishes over time, although ultimate clinical outcome in many studies, including the observational arm of sport, slightly favors surgery. Surgical methods evolved over the period. Laminectomy to less invasive inter-laminar fenestration for disc excision has become gold standard with the surgical method being cost effective. Micro-surgical techniques were developed in late 1980s which gave promising and encouraging results by its minimally invasive method, better visualization. Conclusion: Micro-lumbar discectomy compared to standard open discectomy gives immediate encouraging results in terms of JOA and VAS scores due to small incision, less tissue retraction and damage, short duration of surgery, less bleeding, and better visualization of the nerve roots.