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Published on: August 7, 2018
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Multidimensional long-term outcome analysis after single-level lumbar microdiscectomy: a retrospective single-centre
Sebastian A Ahmadi1, Ilja-Paul Burkert2, Hans-Jakob Steiger2
1Department of Neurosurgery, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. ahmadi@med.uni-duesseldorf.de.
Summary
Early microdiscectomy for lumbar disc herniation (LDH) leads to better long-term outcomes. Delayed surgery, especially beyond one week, significantly worsens results, highlighting the need for timely intervention in lumbar disc herniation (LDH) treatment.
Area of Science:
- Neurosurgery
- Orthopedics
- Spinal Surgery
Background:
- Lumbar disc herniation (LDH) is a common cause of back pain.
- Microdiscectomy is a standard surgical procedure for LDH.
- Long-term outcomes of microdiscectomy require further investigation.
Purpose of the Study:
- To evaluate multidimensional long-term results of mono-segmental microdiscectomy for LDH.
- To analyze outcomes in a large adult cohort treated at a tertiary care center.
Main Methods:
- Retrospective study design.
- Oswestry Disability Index (ODI) questionnaire used for follow-up.
- Analysis of electronic patient records and imaging data for 939 patients undergoing single-level lumbar microdiscectomy (MD) between 2003 and 2009.
Main Results:
- 307 patients (32.7%) completed follow-up at a median of 48 months, with a mean ODI score of 24.04.
- Early surgery (within one week of symptom onset) correlated with significantly lower ODI scores.
- Sequestered herniations showed better outcomes (mean ODI 21.96) compared to contained discs (mean ODI 39.89).
- Complications occurred in 5.6% of cases, and 26.7% required re-operation, often for recurrent disc herniations.
Conclusions:
- Early surgical intervention for lumbar disc herniation (LDH) is associated with superior long-term outcomes.
- Setting time limits for conservative treatment is crucial to prevent pain chronification and poor outcomes from delayed surgery.
- Prompt surgical treatment is particularly beneficial for acute cases with sequestered herniations and minimal immobilization.
