Effect of Preoperative Parameters on Outcomes of Lumbar Microdiscectomy: A Retrospective Analysis

Abstract

Objective The objective of this study was to characterize the effect of preoperative variables on outcomes after minimally invasive lumbar microdiscectomy. Materials and Methods This study was done from January 2019 to May 2020. This included medical records of all patients who were diagnosed with lumbar disc herniation and treated surgically by microdiscectomy. The medical records of such patients from January 2016 to January 2018 were included in this study. Postoperative outcomes were analyzed by Oswestry Disability Index (ODI), visual analog scale (VAS) leg, and VAS back scores, that were noted at preoperative, immediate postoperative, 6 months postoperative, and 1 year after operation. Difference in each outcomes score was calculated postoperatively with respect to the preoperative readings. Minimal clinically important difference was further calculated for each outcome score. Results On analyzing the ODI, VAS leg, and VAS back scores across various age groups, genders, body mass indexes, addictions, comorbidities, preoperative epidural steroid injection and physiotherapy, and levels of disc herniation, and it was found that there was no statistically significant difference across these categories. However, the ODI scores (∼ ODI) at all time points showed greater difference in the younger age group, that is, 18 to 30 years, males, nonsmokers, those with symptom duration of less than 6 weeks, and with disc herniation at L3 to L4. Conclusion The findings of this study will help to properly counsel patients with regard to the factors mentioned above so as to set realistic expectations, to help improve the outcomes, and for appropriate surgical decision making, that is, at which point should a surgical intervention be made.

Back pain and radicular pain after lumbar microdiscectomy

“…In line with previous research, no significant effect of sex or age on the magnitude of postoperative pain relief was found [ 7 , 13 , 15 ]. A few previous studies from the same research team have suggested that older age and female sex might predict worse outcome of microdiscectomy [ 12 , 15 , 20 ].…”

“…Microsurgical excision of herniated lumbar intervertebral disc is a widely accepted generally safe and often effective treatment to ease back and leg pain intensity and disability severity [ 1 – 7 ]. However, while multiple studies have reported significant improvement after the procedure concerning both the severity of pain and the level of disability, it has usually been reported that the procedure might affect radicular leg pain more substantially than local back pain.…”

Back Pain and Radicular Pain After Lumbar Microdiscectomy

“…In line with previous research, no signi cant effect of gender or age on the magnitude of postoperative pain relief was found [7,13,15]. Few previous studies from the same research team have suggested that older age and female gender might predict worse outcome of microdiscectomy [12].…”

“…Microsurgical excision of lumbar intervertebral disc displacement is a widely accepted generally safe and often effective treatment to ease back and leg pain [1][2][3][4][5]. Multiple studies have reported signi cant improvement after the procedure concerning both the severity of pain and the level of disability [6,7].…”

Clinical Effectiveness and Return to Work Rate After Lumbar Total Disk Replacement and Microsurgical Lumbar Discectomy in Railway Workers: a Prospective Randomized Controlled Trial

“…In cases of ineffectiveness of conservative measures for resolve patient clinical symptoms, a microsurgical discectomy using is used to remove the herniated intervertebral disk (IVD) and decompress the symptomatic nerve [3]. It was found that after lumbar discectomy have risk for symptom recurrence, loss of disc height with postoperative radiculopathy and reoperation associated with recurrent herniation [4,5].…”