Comparison of clinical outcomes of unilateral biportal endoscopic technique and open technique of discectomy in lumbar disc herniation

Lumbar disc herniation (LDH) is a prevalent cause of lower back pain and sciatica, primarily occurring at the L4-L5 or L5-S1 levels. While most cases respond to conservative treatment, surgery is indicated for patients with persistent symptoms or neurological deficits. The standard surgical approach, open lumbar discectomy (OLD), is effective but associated with higher tissue damage, postoperative pain, and longer recovery. Minimally invasive techniques like Unilateral Biportal Endoscopic Discectomy (UBE) offer advantages such as reduced muscle trauma, shorter hospital stays, and faster recovery.

This randomized controlled study will be conducted at Maulana Azad Medical College, comparing clinical outcomes of UBE and OLD in patients aged 18–60 years with confirmed LDH unresponsive to conservative treatment. The primary outcome assessed is the change in Visual Analogue Score (VAS) at 2 weeks and 6 months. Secondary outcomes include Oswestry Disability Index (ODI), Macnab score, intraoperative blood loss, surgical duration, hospital stay, and biochemical markers of muscle injury (CPK, LDH, CRP, ESR). With a sample size of 11 patients per group, the study aims to evaluate the invasiveness and efficacy of both techniques. Follow-ups are scheduled at 2 weeks, 6 weeks, 3 months, and 6 months to monitor recovery and outcomes.