Surgical Management of Degenerative Lumber Spine Disease: A Comparative Study of Microdisectomy Versus Open Disectomy

Background Degenerative lumbar spine disease (DLSD) is a prevalent condition that significantly impacts quality of life. Surgical interventions, including microdiscectomy and open discectomy, are commonly used to treat symptomatic lumbar disc herniation. However, the comparative effectiveness of these procedures remains a subject of ongoing research. Objective This study aims to compare the clinical outcomes of microdiscectomy and open discectomy in patients with degenerative lumbar spine disease, focusing on pain relief, functional recovery, complications, and patient satisfaction. Methods A total of 600 patients (309 microdiscectomy, 291 open discectomy) were included in this prospective cohort study. Data were collected on demographic characteristics, preoperative and postoperative pain scores, functional recovery (measured by Oswestry Disability Index), and complications. Logistic regression and multiple linear regression models were employed to predict outcomes, and random forest analysis was used to identify key predictors of complications. Results Microdiscectomy was associated with significantly better postoperative outcomes, including reduced pain (213/309 (69%) vs. 146/291 (50%)), faster recovery (mean recovery time 5.2 weeks vs. 7.6 weeks), fewer complications (46/309 (14.9%) vs. 67/291 (23%)), and higher patient satisfaction (101/309 (32.8%) vs. 73/291 (25%)). Additionally, microdiscectomy also resulted in larger overall improvements in functional recovery and mobility scores compared to open discectomy. Conclusion Microdiscectomy provides superior results in pain relief, recovery time, and complication rates compared to open discectomy. This supports recommending microdiscectomy (with proper patient selection) for most patients with lumbar disc herniation.