Retrospective analysis of microsurgical and standard lumbar discectomy

Abstract

This report retrospectively evaluates 112 cases of microsurgical lumbar discectomy (MICRO) and 35 cases of standard discectomy (STND) performed by one neurosurgeon using data derived from a questionnaire and from chart review. The total amount of postoperative pain medication consumed and postoperative temperature curves in each group were compared to determine how postsurgical morbidity was affected by the MICRO and STND procedures. At a mean follow-up interval of 12.3 and 41 months, 97% of the MICRO respondents reported a good or excellent outcome. Patients with preoperative symptoms exceeding 6 months returned to work in 9.9 +/- 1.7 weeks; this interval decreased to 5.58 +/- 0.75 weeks, and overall outcome score improved significantly at 41 months' follow-up if symptoms were less than or equal to 6 months in duration before surgery. At 44 months' mean follow-up, 88% of the STND respondents reported a good or excellent outcome with no decrease in the return-to-work interval in patients who described symptoms of 6 months or less. Mean postoperative pain medication consumed by MICRO patients was one tenth that of STND patients, and temperature curves showed significant temperature elevations in the STND group when compared with the MICRO group, in which patients remained afebrile throughout the postoperative period. Within the limitations of a retrospective study, these data support the conclusion that a microsurgical approach to the lumbar herniated disc provides a more frequent and rapid convalescence than the STND approach.