Comparative Study between Interlaminar Endoscopic versus Microscopic Lumbar Discectomy for Treatment of Sciatica

BACKGROUND: One of the most common reasons for sciatica is disc herniation, which is disc leakage (nucleus pulposus) into the surrounding neural tissue because of cracks in the annulus fibrosus. Disc degeneration, which the individual’s spine experiences throughout the course of their lifetime because of mechanical stress, is the root cause of these fissures. The first line of treatment of sciatica is conservative. Failed medical treatment for more than 6 weeks indicates surgical intervention. Surgical treatment of sciatica is now minimally invasive either endoscopic or microscopic.OBJECTIVE: The purpose of this study is to evaluate inter-laminar endoscopic and microscopic lumbar discectomy procedures for the surgical treatment of sciatica caused by herniated lumbar discs.METHODS: Fifty patients were studied retrospectively during the period January 2023 to June 2024, with 6 months follow-up duration. Twenty-five patients underwent inter-laminar endoscopic lumbar discectomy (IELD) and another 25 patients underwent microscopic lumbar discectomy (MLD).RESULTS: Both groups I and II had high levels of pre-operative pain (Lower limb and LBP). All cases in both groups had a smooth and uneventful surgery except 1 case in each group that developed a small dural tear, without postoperative CSF leakage. Group I recovered functionally more quickly and had a shorter hospital stay, with 80% being discharged within the 1st post-operative day.CONCLUSION: When it comes to treating sciatica caused by a single level postero-lateral lumbar disc herniation (LDH), there are 2 effective surgical options; inter-laminar endoscopic lumbar discectomy (IELD) and microscopic lumbar discectomy (MLD). The IELD has faster recovery (modified Oswestry disability index (ODI) 4.0 ± 2.58 compared to 4.15 ± 3.37 in MLD), and less tissue damage (intra-operative blood loss 14 ± 0.4 milliliters (mL) compared to 30 ± 0.7 mL in MLD). On the other hand, MLD is a dependable and standardized technique that yields similar results. It may be preferred in cases that require extensive decompression.