Morphological changes after open lumbar microdiscectomy at 2-year follow-up

Area of Science:

• Spinal surgery outcomes
• Lumbar microdiscectomy effects
• Morphological changes in the spine

Background:

• Open lumbar microdiscectomy (OLM) may lead to decreased disc height (DH) and foraminal size, potentially causing long-term pain.
• Limited data exists on the short- and long-term pathoanatomical and morphological consequences of microdiscectomy.
• The precise timeline of DH changes following microdiscectomy remains unclear.

Purpose of the Study:

• To investigate the morphological alterations in disc height (DH) and foramen dimensions after open lumbar microdiscectomy (OLM).
• To provide insights into the pathoanatomical and morphological effects of microdiscectomy over time.

Main Methods:

• Patients undergoing single-level OLM for lumbar disc herniation were included.
• Pre-operative and 2-year post-operative MRI scans were analyzed.
• Measurements included disc height (DH), foraminal area (FA), foraminal height (FH), and widths (SFW, IFW) bilaterally.

Main Results:

• A significant postoperative increase in DH (average 5.5%) was observed across all vertebral levels.
• Foraminal dimensions, including FH, SFW, IFW, and FA, showed a trend towards increase at the 2-year follow-up.
• Mean right FH increased from 15.3 mm to 15.7 mm (p=0.062), and mean left FH from 14.8 mm to 15.8 mm (p=0.271).

Conclusions:

• Contrary to common belief, single-level unilateral OLM may result in increased DH and foramen size at 2 years post-surgery.
• These findings suggest a potential for positive morphological changes following OLM, warranting further investigation.
• Larger sample sizes and longer follow-up periods are recommended to validate these observations.