الفهرس 
AnatomyOnly 14 pages are availabe for public view
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Abstract
Summary
A patient with lumbar disc disease requires a through evaluation by a clinician. Potential sources for pain and neurological deficit must be ruled out by appropriate diagnostic imaging or electromyoraphic studies, or both. After the diagnosis has been narrowed to the pathology of the lumbar spine, an appropriate treatment plan should be formulated for the patient. The degree and extent of neurological injury determine the need for conservative or surgical management. Patients with bladder or bowel disturbance or motor deficit require urgent surgical intervention .But patient with sciatica alone or with sensory deficit may give him a chance for conservative management..
Fenestration and other minimal invasive techniques as microscopic discectomy ,Laser discectomy ,percutaneous and suction discectomy &chemonucleosis are recent techniques for surgical treatment of lumbar disc prolapse .these techniques are minimally invasie to the patient as there is minimal manipulation and allow patients to rapid return to their ordinary work ,dose not affect stability ,decrease hospital staying and decrease incidence of post operative low back
This study was conducted on 60 patients was admitted at Al-Minya University hospital aiming to evaluate the difference between two lines of surgical treatment A) laminectomy, and B) fenestration as regard improving of neurological deficit ,post operative hospital staying ,stability and time of return to ordinary work .
The study showed that 25 patints of group A who suffering from sciatica alone show complete recovery after surgery . 5 patients who are complaining of foot drop 3 of theme improved after surgery and 2 patints were not improved .18 patient of group B show complete relieve of sciatic pain .And 12 patients still complaining 7 of theme are re explored
In 20 patient of group A (66,6%) and 18 patient of group B (60%) low back pain is relieved.
Our study demonstrate that discectomy by laminectomy give more better results than fenestration as there is complete relive of neurological deficit ,no recorded case of post-operative spondylolithesthes and most patients return to there work . A randomized trial is necessary to confirm our results.