Clinical outcome of lumbar discectomy by modified fenestration vs traditional laminectomy and discectomy in lumbar disc herniation.

Objective: To compare clinical outcomes of modified fenestration versus traditional laminectomy and discectomy for lumbar disc herniation (LDH). Study Design: Comparative study Setting: Neuro Spine Unit, Capital Hospital, Islamabad. Period: March 2020 and March 2023. Methods: 50 patients (32 males, 18 females) with LDH unresponsive to conservative treatment underwent surgery at RIHS and Capital Hospital CDA. Group A (n=25) received conventional laminectomy and discectomy, while Group B (n=25) underwent discectomy by modified fenestration. Clinical outcomes were assessed over a 12-month follow-up. Results: Group B showed superior clinical outcomes, with greater relief from back and leg pain, reduced numbness, and improved neurological function compared to Group A. Two cases of intraoperative CSF leakage required dural repair, and five patients experienced postoperative wound infections, managed per culture sensitivity results. The study is relatively small sample size and limited follow-up duration may affect the generalizability of the findings. This study highlights the effectiveness of the modified fenestration technique in LDH management, contributing to the growing body of literature on minimally invasive spine surgery and offering valuable clinical insights for neurosurgeons. Conclusion: The modified fenestration technique yielded better clinical outcomes in terms of pain relief, neurological improvement, and spinal stability after 12 months.