Microdiscectomy for the treatment of lumbar disc herniation: an evaluation of reoperations and long-term outcomes.

ABSTRACT: Design?Retrospective case series. Objective?The objective of this study was to assess the reoperation rate after microdiscectomy for the treatment of lumbar disc herniation (LDH) in patients with???5-year follow-up and identify demographic, perioperative, and outcome-related differences between patients with and without a reoperation. Methods?The medical records, operative reports, and office notes of patients who had undergone microdiscectomy at a single institution between March 1994 and December 2007 were reviewed and long-term follow-up was assessed via a telephone questionnaire. Results?Forty patients (M:24, F:16) with an average age at surgery of 39.9?±?12.5 years (range: 18-80) underwent microdiscectomy at the levels L5-S1 (n?=?28, 70%), L4-L5 (n?=?9, 22.5%), L3-L4 (n?=?2, 5.0%), and L1-L2 (n?=?1, 2.5%). After an average of 40.4?±?40.1 months (range: 1-128), 25% of patients (10/40) required further spine surgery related to the initial microdiscectomy. At an average postoperative follow-up of 11.1?±?4.0 years (range: 5-19), additional symptoms apart from back and leg pain were reported more frequently by patients who underwent a reoperation (p?=?0.005). Patient satisfaction was significantly higher in patients who did not undergo a reoperation (p?=?0.041). For the Oswestry disability index, pain intensity (p?=?0.036), and pain-related sleep disturbances (p?=?0.006) were reported to be more severe in the reoperation group. Conclusions?Microdiscectomy for the treatment of LDH results in a favorable long-term outcome in the majority of cases. The reoperation rate was higher in our series than reported in previous investigations with shorter follow-up. Although there were no statistically significant pre-/perioperative differences between patients with and without reoperation, our findings suggest a difference in self-reported long-term outcome measures.

SUBMITTER: Aichmair A 

PROVIDER: S-EPMC4174230 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature