Introduction: It is a well recognized fact that a significant proportion of patients operated on for lumbar disc herniation exhibit a poor outcome, regardless of the apparent technical success of the operative procedure itself. Aim: to identify a set of widely available variables that accurately predict short-term outcome after discectomy and to develop a predictive model based upon those variables. Patients and methods: Basic demographic, clinical and radiological variables were evaluated in a group of 70 patient operated on for disc herniation. Outcome was assessed using VAS and RM scales 6 months postoperatively and correlated to aforementioned variables. Results: Preoperative pain intensity and duration, age and type of disc herniation were all shown to be statistically significant predictors of short-term outcome, unlike sex, type of radiological investigation and preoperative tension sign testing results. Multivariate regression analysis including only variables previously identified as good outcome predictors revealed that the pain intensity exhibited the strongest correlation with outcome, followed by pain duration, type of disc herniation and age. Even though MR scan was more sensitive in detecting disc extrusion than CT (sensitivity of 100% versus 65%, respectively), the presence of preoperative MR scan did not influence the outcome. Conclusion: The study identified a set of widely available and easily attainable variables as fair predictors of short-term outcome after lumbar discectomy. Subsequent logistic regression resulted in a predictive model whose accuracy is to be determined in another prospective study

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Background: Many apparent advantages of the magnetic resonance imaging (MRI) in establishing diagnosis of lumbar disc herniation are counter parted by its relatively high cost and sparse availability in developing countries. Thus, a significant portion of patients are still subjected to lumbar disc surgery based solely on computed tomography (CT) findings. Aim: The aim of this study was to compare diagnostic characteristics of afore mentioned radiological tests (CT and MRI) and to investigate if the choice of diagnostic test influences outcome of discectomy. Methods: Basic demographic, clinical and radiological variables were evaluated in a group of 70 patients operated on for disc herniation of whom 30 were operated based on MRI findings and the remainder were operated based on CT scan alone. Outcome was assessed using Visual Analogue Scale (VAS) and Roland-Morris (RM) scale 6 months postoperatively and correlated to the type of neuroradiological examination. Basic diagnostic characteristic of the two diagnostic modalities (MR and CT) were compared. Results: The type of radiological investigation was shown to be statistically poor predictor of outcome after microdiscectomy. Even though MR scan was more sensitive in detecting disc extrusion than CT (sensitivity of 100% versus 65%, respectively), the presence of preoperative MR scan did not influence the outcome. Conclusion: We conclude that although the presence of preoperative MR scan does not influence outcome, higher sensitivity and specificity in detecting disc extrusions and superior ability to detect nerve root compression warrant an introduction of MR scan prior to any disc surgery