Early outcomes of open laminectomy with discectomy for single-level lumbar disc herniation

Background: Lumbar disc herniation is a common cause of lumbosacral radiculopathy and functional disability. Although minimally invasive techniques are increasingly used, open laminectomy with discectomy remains common technique in resource-limited settings. Data on early postoperative outcomes are limited. This study aimed to evaluate the proportion of patients achieving clinically meaningful pain relief and functional improvement one month after open laminectomy with discectomy for single-level lumbar disc herniation. Methods: This descriptive study was conducted at Department of Neurosurgery and Spine Surgery, Hayatabad Medical Complex, Peshawar, from February to May 2026. 127 patients aged 18–60 years with MRI-confirmed single-level lumbar disc herniation refractory to conservative treatment were enrolled consecutively and underwent open laminectomy with discectomy. Pain and disability were assessed preoperatively and at one month follow-up using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI). Clinically meaningful improvement was defined as a ≥30% reduction in VAS and a ≥15-point reduction in ODI. Early postoperative complications were recorded. Results: The mean age was 42.8 ± 9.7 years; 59.8% were male and 40.2% female. Mean VAS decreased from 7.9 ± 1.1 preoperatively to 2.3 ± 1.4 at one month, representing a 70.9% reduction (p <0.001). Mean ODI decreased from 56.4 ± 11.8 to 21.7 ± 9.5, representing a 61.5% improvement (p <0.001). Overall, 93 patients (73.2%; 95% CI: 64.9–80.2%) achieved clinically meaningful improvement. Early complications occurred in 9 patients (7.1%), including wound infection, cerebrospinal fluid leak, recurrent disc herniation, and transient neurological deterioration. No mortality or permanent neurological deficits occurred. Conclusion: Open laminectomy with discectomy produced substantial early improvement in pain and functional disability, with a low frequency of early postoperative complications. It remains a practical treatment option for single-level lumbar disc herniation in resource-limited settings.