Functionality Status and Surgical Outcome of Fenestration versus Laminotomy Discectomy in Patients with Lumbar Disc Herniation

Background & Aim: To assess functionality status and surgical outcome of fenestration versus laminotomy technique based on Core Outcome Measures Index (COMI) in patients with lumbar disc hernia (LDH). Methods & Materials/Patients: A cross-sectional study was performed between January 2007 and April 2012. A total of 108 patients with a single-level disc herniation were asked to respond to the Oswestry Disabiltiy Index (ODI) and COMI at two points in time: pre- and post-operative assessments. The ODI and COMI were assessed comparing patients’ pre- and postoperative scores to determine the functionality status and surgical outcome. Results: The mean age of patients was 52.4 (SD=10.1) years who underwent fenestration (n=45) or laminotomy discectomy (n=63). The mean clinical follow-up was 27.8 (SD=3.6) months (range 24 - 37 months). Regarding COMI scores, all subgroup values showed statistical significance pre- and postoperative indicating improvements on the outcomes and functionality. The change in the ODI after surgery was strongly correlated with change in the COMI, (r=0.79; P<0.001). The ODI score also was found to be statistically different between the groups in pre-and postoperative (P<0.001) assessment. However, the functionality status rate was similar in both groups. Conclusion: The findings suggest that fenestration or laminotomy discectomy is an efficacious procedure for treatment of LDH. However, both methods are equally effective in surgical outcome.