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. 2022 Feb;31(2):400-407.
doi: 10.1007/s00586-021-07074-x. Epub 2022 Jan 7.

Microdiscectomy for sciatica: reality check study of long-term surgical treatment effects of a Lumbosacral radicular syndrome (LSRS)

Michiel B Lequin  1   2 , Dagmar Verbaan  3 , Peter R Schuurman  3 , Saskia Tasche  4 , Wilco C Peul  5 , William P Vandertop  3 , Gerrit J Bouma  3   4
Affiliations

Microdiscectomy for sciatica: reality check study of long-term surgical treatment effects of a Lumbosacral radicular syndrome (LSRS)

Michiel B Lequin et al. Eur Spine J. 2022 Feb.

Abstract

Purpose: It remains unclear whether the long-term results of RCTs regarding the outcome of microdiscectomy for lumbosacral radicular syndrome (LSRS) are generalizable. The purpose of this study was to determine the external validity of the outcome preseneted in RCTs after microdicectomy for LSRS in a patient cohort from a high-volume spine center.

Methods: Between 2007 and 2010, 539 patients had a single level microdiscectomy for MRI disk-related LSRS of whom 246 agreed to participate. Questionnaires included visual analogue scores (VAS) for leg pain, RDQ, OLBD, RAND-36 and Likert scores for recovery, leg and back pain. Lumbar re-operation(s) were registered.

Results: Mean age was 51.3, and median time of follow-up was 8.0 years. Re-operation occurred in 64 (26%) patients. Unfavorable perceived recovery was noted in 85 (35%) patients, and they had worse leg and back pain than the 161 (65%) patients with a favorable recovery: median VAS for leg pain 28/100 mm versus 2/100 mm and median VAS for back pain 9/100 mm versus 3/100 mm, respectively. In addition, the median RDQ and OLBD scores differed significantly: 9 vs 3 for RDQ and 26 vs 4 for OLBD, respectively (p < 0.001).

Conclusion: In this cohort study, the long-term results after microdiscectomy for LSRS were less favorable than those obtained in RCTs, possibly caused by less strict patient selection than in RCTs. Our findings emphasize that patients, who do not meet the same inclusion criteria for surgery as in RCTs, should be informed about the chances of a less favorable result.

Keywords: Discectomy; Neurosurgery operative procedure; Spine; Treatment outcome.

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References

    1. Lequin MB et al (2013) Surgery versus prolonged conservative treatment for sciatica: 5-year results of a randomised controlled trial. BMJ Open. https://doi.org/10.1136/bmjopen-2012-002534 - DOI - PubMed - PMC
    1. Overdevest GM et al (2017) Tubular discectomy versus conventional microdiscectomy for the treatment of lumbar disc herniation: long-term results of a randomised controlled trial. J Neurol Neurosurg Psychiatry 88(12):1008–1016 - DOI
    1. Bailey A et al (2013) Prospective, multicenter, randomized, controlled study of anular repair in lumbar discectomy: two-year follow-up. [Erratum appears in Spine (Phila Pa 1976). 2013 Aug 1;38(17):1527]. Spine 38(14):1161–1169 - DOI
    1. Thome C et al (2005) Outcome after lumbar sequestrectomy compared with microdiscectomy: a prospective randomized study. J Neurosurg Spine 2(3):271–278 - DOI
    1. Martin BI et al (2012) Repeat surgery after lumbar decompression for herniated disc: the quality implications of hospital and surgeon variation. Spine J 12(2):89–97 - DOI

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