Operations for Symptomatic Herniated Intervertebral Disk: A Study of 45,048 Patients

Abstract

Long-term results of operations for symptomatic cervical and lumbar disk herniation were analyzed in 45,048 patients.Cervical disks: 6,000 patients were operated for cervical disk herniation and the results of operating anteriorly (anterior diskectomy with/without fusion) were compared to the results of operating posteriorly (laminoforamenotomy/"keyhole" facetectomy). The anterior group (mean follow-up: 5.9 years) had 80% good/excellent results, while the posterior group (mean follow-up: 8.5 years) had 94% good/excellent results (p < 0.05). Perhaps the more complete decompression of the nerve root over time is the reason for the superior long-term outcome.Lumbar disks: 39,048 patients were operated on for lumbar disk herniation. They were divided into three groups: microdiskectomy, endoscopic microdiskectomy and the classical operation (laminectomy/laminotomy with diskectomy). Mean follow-ups were 4.1 years, 2.9 years, and 6.3 years. Good/ excellent results were approximately 80% in all three groups. The same results in each group raises questions about the complete origins of the symptoms in 20% of patients.