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Surgery for extraforaminal lumbar disc herniation: a single center comparative observational study.

Samuel B Polak1, Mattis A Madsbu2,3, Vetle Vangen-Lønne4

  • 1Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands.

Acta Neurochirurgica
|April 15, 2020
PubMed
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Surgery for extraforaminal lumbar disc herniation (ELDH) yields outcomes comparable to paramedian lumbar disc herniation (PLDH). Both procedures show similar patient-reported improvements one year post-operation.

Area of Science:

  • Neurosurgery
  • Orthopedics
  • Spine Surgery

Background:

  • Extraforaminal lumbar disc herniation (ELDH) surgery is common but considered more challenging than paramedian lumbar disc herniation (PLDH).
  • Comparative data on the effectiveness and safety of ELDH versus PLDH surgery were lacking.
  • This study aimed to compare clinical outcomes between ELDH and PLDH surgeries.

Purpose of the Study:

  • To compare the clinical outcomes at one year following surgery for ELDH and PLDH.
  • To evaluate the effectiveness and safety of ELDH surgery in comparison to PLDH surgery.

Main Methods:

  • Data were sourced from the Norwegian Registry for Spine Surgery (NORspine).
  • The primary outcome was the change in Oswestry Disability Index (ODI) at one year.
Keywords:
Intervertebral disc displacementNeurosurgeryOrthopedicsSciatica

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  • Secondary outcomes included EuroQol 5 dimensions (EQ-5D) and numeric rating scales (NRSs) for pain.

    • Main Results:

    • A total of 1750 patients were evaluated, with 72 undergoing ELDH surgery.
    • One year post-surgery, no significant differences were observed in ODI, EQ-5D, or NRS pain scores between ELDH and PLDH groups.
    • Clinical success rates, defined by ODI scores below 20, were similar for both surgical approaches (61.5% for ELDH vs. 52.7% for PLDH).

    Conclusions:

    • Patients undergoing surgery for ELDH experience comparable clinical improvements at one year to those treated for PLDH.
    • The findings suggest that ELDH surgery is as effective as PLDH surgery in terms of patient-reported outcomes.