Microdiscectomy: An Observational Study. The New Armenian Medical Journal

Abstract

Intervertebral disc herniation, which is an inevitable and aging process due to intervertebral discs unique anatomical and physiologic characteristics and spine biomechanics, can lead to compression of one or more nerve roots, producing radiculopathy. There are two treatment options non-surgical and surgical or the combination of both depending on individual clinical findings for this issue. Surgical management includes several options with different success and complications rate. The options also have different implementation rate. The aim of current study is to show the efficacy and safety of microdiscectomy as a surgical treatment option in our clinical practice. We enrolled 91 patients from 2019 to 2021, who were operated using microdiscectomy technique, discharged within few days and were prescribed to use semi-hard lumbar brace for a month and were followed up until 2022 November. No any patient was considered as a surgical management candidate simply for low back pain. Immediate and complete or nearly-complete pain relief, sensory deficit and motor weakness improvement were the predictors of surgical management success and were achieved in all patients. There were no cases of intraoperative complications and failed back surgery. One patient (1.1%, 1/91) developed cerebrospinal fluid leakage from the wound on postoperative day 7, which resolved with additional dermal sutures. Recurrence rate of disc herniation was 1.1% (1/91). This patient was successfully reoperated without significant quality of life affection. The implementation of microdiscectomy technique in our clinical practice was successful, and from medical point of view highly effective and safe surgical management option for treatment of disc herniation with radiculopathy in cases where non-surgical management options failed to resolve the issue or there were indications for urgent surgical management. We hope that this technique eventually will become a gold standard for surgical treatment of disc herniation with radiculopathy in Armenia.