Full-Endoscopic vs Open Discectomy for the Treatment of Symptomatic Lumbar Herniated Disc

Inclusion Criteria: 1. Patient equal to or greater than 18 years old. 2. Patients with single level para-central herniated discs from L1-S1. 3. VAS (Visual Analog Scale) leg \> 40 mm. 4. Leg pain must be greater than back pain. 5. Minimum 6 weeks conservative treatment unless motor strength U\< U4/5 and or deteriorating neurologic function. Exclusion Criteria: 1. Lateral/subarticular, far lateral disc herniations 2. Multi-focal (multi modal) disc herniations 3. Symptomatic multiple level disc herniations 4. Active infection either spinal or otherwise 5. Prior history of lumbar spinal infection at any level 6. Spinal tumor in lumbar region 7. Dynamic (any grade) or fixed spondylolisthesis more than 3mm 8. Disc extrusion that is more superior than most inferior aspect of superior pedicle above index disc level 9. Disc extrusion that is more inferior than the middle aspect of inferior pedicle below the index disc level 10. Presence of unilateral or bilateral pars inter articularis defects (spondylolysis) 11. Disc herniation which is significantly calcified 12. Contra-lateral leg pain U\>40 mm 13. History of peripheral diabetic neuropathy 14. Significant central stenosis with history of neurogenic claudication 15. Pregnancy 16. Facet cyst on symptomatic side 17. Cauda Equina syndrome past or present 18. Patients cannot have had prior lumbar surgery including IDET (Intradiscal Electrothermal Therapy) or other percutaneous surgical procedures. 19. Significant vascular claudication 20. History of radiation to the spinal column 21. History of malignancy of any type within 2 years of consideration of enrollment