Comparison Between Open Microdiscectomy and Endoscopic Discectomy: A Case Series (65 Patients) and Literature Review

Introduction: Lumbar disc herniation is commonly treated conservatively, but surgery is necessary when symptoms persist. Open microdiscectomy and endoscopic discectomy are two widely used surgical techniques, with the latter offering a less invasive approach. This study compares their clinical outcomes. Objective: To compare open microdiscectomy and endoscopic discectomy in terms of pain relief, hospital stay, opioid use, return to work, recurrence rates, and complications. Methods: A retrospective analysis of 65 patients (30 open microdiscectomy, 35 endoscopic discectomy) who underwent surgery between 2023 and 2024. Key parameters, including pain relief (VAS scores), opioid use, complications, and return to work, were compared. Results: Both techniques showed similar pain relief and surgery duration. Endoscopic discectomy had a significantly higher rate of dysesthesia (34.3% vs. 3.3%, p=0.0051). Return to work at 60 days showed no significant difference (p=0.7018). Reoperation rates were low in both groups (3.3% vs. 5.7%). Discussion: Both approaches provided effective pain relief, but endoscopic discectomy was associated with a higher rate of dysesthesia. Return to work was more influenced by personal factors than the surgical technique. Both techniques showed low reoperation rates and good long-term outcomes. Conclusion: Open microdiscectomy and endoscopic discectomy are comparable in terms of pain relief, recovery, and reoperation rates, though endoscopic discectomy has a higher risk of dysesthesia. The choice of technique should be based on patient and surgeon factors.