title: Microdiscectomy or tubular discectomy: Is any of them a better option for management of lumbar disc prolapse.
abstract: OBJECTIVE
  Various types of minimally invasive techniques have been developed for the treatment of lumbar disc herniation. The original laminectomy was refined into microdiscectomy (MD). MD is the gold standard in management of lumbar disc herniation and is used as a yardstick for comparison with newer procedures such as tubular discectomy. So far, no studies have been reported in Indian population comparing tubular discectomy and microdiscectomy. The aim of this study was to compare immediate postoperative and 1-year outcome of patients undergoing tubular discectomy with those undergoing MD and to evaluate the learning curve as well as complication rates of tubular discectomy.
  
  
  METHODS
  Forty-six patients of MD and 102 (48 early and 54 late) patients of tubular discectomy (TD) were operated at Indian Spinal Injuries Centre, which is a tertiary level center between July 2009 and January 2012. They were studied for the following data: Baseline characteristics, visual analog scale (VAS) for leg pain and back pain, Oswestry Disability Index (ODI) scores, length of hospital stay, time taken to return to work, duration of surgery, intra- and post-operative complications, and reoperation rates.
  
  
  RESULTS
  The VAS score for leg pain, back pain, and ODI scores showed improvement in both groups during the 1(st) year after surgery. Time taken to return to work and mean hospital stay was shorter in case of TD as compared to MD group. The mean duration of surgery was 34 min shorter for conventional MD. The incidence of dural tear was 6.5% in MD group and 10.4% in early TD and decreased to 7.4% in late TD group.
  
  
  CONCLUSIONS
  This study revealed that rate of recovery is significantly faster for TD as compared to conventional MD. In contrast, we encountered fewer complications in MD approach as compared to TD which although were not statistically significant and which also decreased as we gained experience.
authors.affiliation: Department of Spine, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: Pallav S
authors.initials: PS
authors.lastname: Bhatia
authors.affiliation: Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: Harvinder S
authors.initials: HS
authors.lastname: Chhabra
authors.affiliation: Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: Bibhudendu
authors.initials: B
authors.lastname: Mohapatra
authors.affiliation: Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: Ankur
authors.initials: A
authors.lastname: Nanda
authors.affiliation: Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: Gururaj
authors.initials: G
authors.lastname: Sangodimath
authors.affiliation: Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Kaul
keywords: Complications; learning curve; microdiscectomy; outcomes; tubular discectomy