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Published on: August 7, 2018
Long-Term Results of Various Operations for Lumbar Disc Herniation: Analysis of over 39,000 Patients
George J Dohrmann1, Nassir Mansour
1Section of Neurosurgery, University of Chicago Medical Center, Chicago, Ill., USA.
Insights
Long-term follow-up of lumbar disc herniation surgeries shows similar outcomes across procedures. Microdiscectomy, endoscopic microdiscectomy, and classical laminectomy/laminotomy with discectomy all yield approximately 79% good to excellent results.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Lumbar disc herniation is a common condition requiring surgical intervention.
- Various surgical techniques exist for treating lumbar disc herniation, each with potential differences in long-term outcomes.
- Assessing the comparative long-term efficacy of these procedures is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate and compare the long-term follow-up results of different surgical operations for lumbar disc herniation.
- To analyze patient-reported outcomes across various surgical modalities in a large cohort.
- To determine if specific surgical techniques offer superior long-term benefits for lumbar disc herniation.
Main Methods:
- A systematic literature review was conducted to identify studies on lumbar disc herniation surgeries.
- Data from 39,048 patients with follow-up periods of at least 2 years were analyzed.
- Surgical groups included microdiscectomy, endoscopic microdiscectomy, and classical laminectomy/laminotomy with discectomy, with outcomes graded by patients.
Main Results:
- Overall, 78.9% of 39,048 patients reported good/excellent results after a mean follow-up of 6.1 years.
- Microdiscectomy (n=3,400) showed 84.3% good/excellent results (mean follow-up 4.1 years).
- Classical laminectomy/laminotomy with discectomy (n=34,547) yielded 78.3% good/excellent results (mean follow-up 6.3 years), similar to endoscopic microdiscectomy (79.5% good/excellent results).
Conclusions:
- Long-term analysis of 39,048 patients indicates comparable outcomes for microdiscectomy, endoscopic microdiscectomy, and classical laminectomy/laminotomy with discectomy.
- Approximately 79% of patients reported good to excellent results regardless of the surgical procedure employed.
- No significant difference in long-term outcomes was observed among the evaluated surgical techniques for lumbar disc herniation.
Objective:
To determine the long-term follow-up of the various operations for lumbar disc herniation in a large patient population.
Subjects And Methods:
Patients who had operations for lumbar disc herniation (microdiscectomy, endoscopic microdiscectomy and the 'classical operation', i.e. laminectomy/laminotomy with discectomy) were collected from the world literature. Patients who had follow-ups for at least 2 years were analyzed relative to the outcome. The outcome was graded by the patients themselves, and the operative groups were compared to one another.
Results:
39,048 patients collected from the world literature had had lumbar disc operations for disc herniations. The mean follow-up period was 6.1 years, and 30,809 (78.9%) patients reported good/excellent results. Microdiscectomy was performed on 3,400 (8.7%) patients. The mean follow-up was 4.1 years with 2,866 (84.3%) good/excellent results, while 1,101 (3.6%) patients had endoscopic microdiscectomy. There, the mean follow-up was 2.9 years with 845 (79.5%) good/excellent results. The classical operation was performed on 34,547 (88.5%) patients with a mean follow-up period of 6.3 years, and 27,050 (78.3%) patients had good/excellent results. These results mirror those with discectomy and the placement of prosthetic discs.
Conclusions:
The analysis of 39,048 patients with various operations for lumbar disc herniation revealed the same pattern of long-term results. Patients who had microdiscectomy, endoscopic microdiscectomy or the classical operation (laminectomy/laminotomy with discectomy) all had approximately 79% good/excellent results. None of the operative procedures gave a different outcome. l.
