Abstract
The aim of this study was to evaluate the outcomes of patients with lumbar disk hernia operated between 2012 January and 2017 August and to compare the differences between open discectomy (OD) and microdiscectomy (MD). Files of 519 patients who presented at our neurosurgical department with lumbar disk herniation were retrospectively reviewed and recorded. Preoperatively, all patients routinely underwent spinal lumbar magnetic resonance imaging (MRI) and anteroposterior as well as lateral lumbar vertebrae X-rays. During the early postoperative period, there was no need for imaging. Surgical interventions were performed using the two currently accepted OD and MD methods. We reviewed 519 patients with lumbar disk herniation who were operated in our clinic between 2012 and 2017. The mean age of 276 patients who underwent OD was 44.85±9.92 y, and that of the remaining 243 patients who underwent MD was 47.69±12.87 y. There was no difference in the demographic distributions of patients; levels of lumbar disk herniations; postoperative clinical outcomes; and long-term reoperation rates due to root injury, wound infection, dural tear, or the recurrence of lumbar disk herniation (p>0.05). The duration of operation was significantly shorter for OD (37.82±7.15 vs. 49.07±6.88 min; t=-18.184, p<0.001). The long-term results of patients who underwent OD and MD for lumbar disk herniation were similar. We believe that both methods can be safely used under appropriate conditions and surgical experience and that surgical experience has an impact on their outcomes.
Highlights
The incidence of lumbar disc herniation (LDH) has varied between studies [1,2,3]
We reviewed 519 patients with lumbar disk herniation who were operated in our clinic between 2012 and 2017
The duration of operation was significantly shorter for open discectomy (OD) (37.82±7.15 vs. 49.07±6.88 min; t=−18.184, p
Summary
The incidence of lumbar disc herniation (LDH) has varied between studies [1,2,3]. The incidence of back pain in a population has been reported to be roughly around 60% and that of sciatica has been reported to be 1% [1]. MD constitutes the standard treatment method for LDH. The MD method produces less tissue damage than conventional open discectomy (OD) and, leads to less epidural fibrosis, postoperative back pain, radicular pain, and segmental instability [4,5,6,7]. With improvements in endoscopy, a more minimally invasive microendoscopic discectomy (MED) method has begun to be used. Microsurgery and sequestrectomy have been suggested to be advantageous in early-stage comparisons in selected cases, several other studies have not found significant differences in the long-term follow-ups [8, 9]
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