Hamawandi SA, et al. - In this study, the results of fenestration microdiscectomy with open fenestration discectomy were compared 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. Researchers randomly divided sixty patients age (29 - 50 years), with L4-L5 disc herniation into group A- 30 patients had undergone an open fenestration discectomy- and group B- 30 patients had undergone fenestration microdiscectomy. After surgery, all individuals are evaluated at 1 week, 3 months, 6 months, 12 months for the Oswestry disability index, and visual analogue scale for back pain and leg pain and followed up for 4 years. The data indicated that for the treatment of symptomatic lumbar disc herniation, use of the microscope in fenestration discectomy can achieve the same goals of open fenestration regarding nerve root decompression and relief of leg pain with advantage of less back pain, less hospital staying and early return to daily activities with disadvantage of more cost with the use of microscope. With 4 years follow up, no significant difference was noted in the rate of recurrence and reoperation with the use of microscope but they noted that type of surgery for recurrent cases may be less invasive whether microscope was applied in primary surgery.