title: Long term results of lumbar sequestrectomy versus aggressive microdiscectomy.
abstract: It remains unknown whether aggressive microdiscectomy (AD) provides a better outcome than simple sequestrectomy (S) with little disc disruption for the treatment of lumbar disc herniation with radiculopathy. We compared the long term results for patients with lumbar disc herniation who underwent either AD or S. The patients were split into two groups: 85 patients who underwent AD in Group A and 40 patients who underwent S in Group B. The patients were chosen from a cohort operated on by the same surgeon using either of the two techniques between 2003 and 2008. The demographic characteristics were similar. The difference in complication rates between the two groups was not statistically significant. During the first 10 days post-operatively, the Visual Analog Scale score for back pain was 4.1 in Group A and 2.1 in Group B, and the difference was statistically significant (p<0.005). The Oswestry Disability Index score was 11% in Group A and 19% in Group B at the last examination. The reherniation rate was 1.5% in Group A and 4.1% in Group B (p<0.005). We argue that reherniation rates are much lower over the long term when AD is used with microdiscectomy. AD increases back pain for a short time but does not change the long term quality of life. To our knowledge this is the first study with a very long term follow-up showing that reherniation is three times less likely after AD than S.
authors.affiliation: T.C. İSTANBUL Arel University, Department of Neurologic Sciences, Türkoba Mahallesi Erguvan Sokak No: 26/K, Tepekent, 34537 Büyükçekmece, Turkey. Electronic address: kadirkotil@gmail.com.
authors.forename: Kadir
authors.initials: K
authors.lastname: Kotil
authors.affiliation: Istanbul Educational and Research Hospital, Istanbul, Turkey.
authors.forename: Neslihan Sutpideler
authors.initials: NS
authors.lastname: Köksal
authors.affiliation: T.C. Rize Tayyip Erdoğan University, Rize Merkez, Rize, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Kayaci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology; D015331:Cohort Studies; D004185:Disability Evaluation; D017586:Diskectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D011843:Radiculopathy / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D055815:Young Adult
keywords: Aggressive microdiscectomy; Disc herniation; Lumbar; Sequestrectomy