Background: Fenestration discectomy, for symptomatic lumbar disc herniation, is the most common surgical procedure in spine surgery. It can be done by open or microscopic procedures. This study compared the results of fenestration microdiscectomy with open fenestration discectomy in the treatment of symptomatic lumbar disc herniation as a relation to the functional outcome, leg pain, back pain, hospital stay, returns to daily activity, cost, recurrence, reoperation and type of surgery for recurrent disc herniation. Methods: 60 patients age (29-50 years), with L4-L5 disc herniation, are divided randomly into group A-30 patients underwent an open fenestration discectomy-and group B-30 patients underwent fenestration microdiscectomy. All patients are assessed at 1 week, 3months, 6 months, 12 months after surgery for Oswestry disability index and Visual analogue scale for back pain and leg pain and followed up for 4 years. Results: In both groups, all patients have minimal disability by Oswestry Disability Index after surgery.

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Level II, prognostic study.