Background Data: Recently, transforaminal endoscopic discectomy (TED) has become accepted as a safe alternative procedure for microdiscectomy (MID) in lumbar disc surgery. Numerous studies compared microdiscectomy with interlaminar endoscopic discectomy; however, the number of studies comparing MID with TED is relatively limited. Purpose: To compare TED and MID in treating lower lumbar disc prolapse (LDP) and associated unilateral sciatica in terms of overall outcome, complications, and rate of recurrence. Study Design: Retrospective clinical case series. Patients and Methods: This retrospective study included one hundred patients with low back pain and unilateral sciatica due to lower lumbar herniated discs. They were divided into 2 groups, each one consisted of 50 patients: Group A underwent MID and Group B TED. Clinical assessments of all patients were conducted using Visual Analogue Score (VAS) and Oswestry Disability Index (ODI) preoperatively and at one-year postoperative follow-up. Results: In this study, one hundred patients were surgically treated (50 for MID and 50 for TED) from June 2017 to December 2018. The mean age was 40.44 ± 11.31 and 41.14 ± 11.60 years for MID and TED, respectively. Males were most affected in both TED and MID groups (76% in MID and 66% in TED). The most affected disc level in both groups was the L4-L5 level, representing 60% and 68% for MID and TED, respectively. The mean operative time was 63.82 ± 17.37 and 72.60 ± 16.90 minutes for MID and TED, respectively, with significant difference (p < /em> < 0.05). The mean hospital stay was 29.80 ± 31.73 and 14.76 ± 11.20 hours for MID and TED, respectively, with significant difference (p < /em> = 0.02). Upon comparing the postoperative values, all patients in both groups showed a significant improvement in their preoperative back pain, leg pain, and ODI scores. According to Macnab’s Outcome Criteria, in our study, the results were as follows: for the MED group, overall good to excellent outcomes in 92% (N = 46), fair in 4% (N = 2), and poor in 4% (N = 2); for the TED group, overall good to excellent outcomes in 86% (N = 43), fair in 6% (N = 3), and poor in 8% (N = 4). Conclusion: Percutaneous posterolateral transforaminal discectomy has become a relatively safe and effective procedure over the last years; however, MID is the gold standard surgical approach till now for treating LDP and associated sciatica. (2020ESJ211) Abstract Background Data:
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Ismail et al. (2020) studied this question.