title: Long-term follow-up of standard microdiscectomy versus minimal access surgery for lumbar disc herniations.
abstract: BACKGROUND
  Surgery of lumbar disc herniations is one of the most common neurosurgical procedures. New surgical approaches and techniques are constantly evolving. We present our long-term follow-up results comparing standard open microdiscectomy (SOMD) and minimal access microdiscectomy (MAMD) for single-level lumbar disc herniations.
  
  
  METHODS
  Patients were randomized in two groups receiving either MAMD or SOMD. Physical and mental health and pain relief were assessed (ODI, SF-36 questionnaire, VAS leg and back pain). In addition, all patients received MR imaging for morphological evaluation of postoperative peridural scar tissue formation.
  
  
  RESULTS
  Of the 60 initial patients (SOMD: 30 pts, MAMD: 30 pts), 38 were available for long-term follow-up. Mean follow-up time was 33 months. Long-term follow-up revealed significant postoperative pain relief in both groups. Good to excellent results concerning physical and mental health and pain relief were achieved in both groups. Significantly less peridural scar tissue formation was observed in the MAMD patients, but without clinical impact.
  
  
  CONCLUSIONS
  MAMD is a feasible alternative to the standard open approach. Both groups show significant and long-lasting pain relief and good to excellent results regarding health-related quality of life. Congruent to our short-term results, we observed slightly but not statistically significant better clinical results in the MAMD group when compared to the SOMD group.
authors.affiliation: Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, Ismaningerstr. 22, 81675, Munich, Germany, Jens.Gempt@lrz.tum.de.
authors.forename: J
authors.initials: J
authors.lastname: Gempt
authors.forename: M
authors.initials: M
authors.lastname: Jonek
authors.forename: F
authors.initials: F
authors.lastname: Ringel
authors.forename: A
authors.initials: A
authors.lastname: Preuss
authors.forename: P
authors.initials: P
authors.lastname: Wolf
authors.forename: Y
authors.initials: Y
authors.lastname: Ryang
mesh_terms: D000328:Adult; D001416:Back Pain / Q000209:etiology; D017586:Diskectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006547:Hernia / Q000150:complications; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007405:Intervertebral Disc Displacement; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016896:Treatment Outcome; D055815:Young Adult