title: Surgery for lumbar disc herniation: Analysis of 500 consecutive patients treated in an interdisciplinary spine centre.
abstract: Surgical removal of a symptomatic herniated lumbar disc is performed either with or without the support of a microscope. Up to the time of writing, the literature has reported similar clinical outcomes for the two procedures. Five hundred consecutive patients, operated upon for primary single-level lumbar disc herniation in our University Spine Center between 2003-2011, with (n=275), or without (n=225), the aid of a microscope were included. Data were retrospectively analyzed, comparing the primary endpoint of clinical outcome and the secondary endpoints of complications, surgical time and length of hospitalization. Clinical outcomes and reoperation rates were comparable in both groups. Surgical time was significantly shorter with a mean time of 47minutes without use of the microscope compared to the mean time of 87minutes (p<0.001) with the use of the microscope. Mean length of hospitalization was shorter in those operated with the microscope (5.3days) compared to those without (6.1days, p=0.004). There was no difference in rates of complications. Microdiscectomy versus open sequestrectomy and discectomy for surgical treatment of lumbar disc herniation is associated with similar clinical outcomes and reoperation rates. Open sequestrectomy is associated with shorter operation times. Microdiscectomy is associated with shorter hospitalization stays.
authors.affiliation: Department of Orthopedics, Spine Center, University Hospital Balgrist, University of Zurich, Forchstrasse 340, 8008 Zürich, Switzerland. Electronic address: Samuel.Schmid@balgrist.ch.
authors.forename: S L
authors.initials: SL
authors.lastname: Schmid
authors.affiliation: Department of Orthopedics, Spine Center, University Hospital Balgrist, University of Zurich, Forchstrasse 340, 8008 Zürich, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Wechsler
authors.affiliation: Department of Orthopedics, Spine Center, University Hospital Balgrist, University of Zurich, Forchstrasse 340, 8008 Zürich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Farshad
authors.affiliation: Department of Orthopedics, Spine Center, University Hospital Balgrist, University of Zurich, Forchstrasse 340, 8008 Zürich, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Antoniadis
authors.affiliation: Department of Orthopedics, Spine Center, University Hospital Balgrist, University of Zurich, Forchstrasse 340, 8008 Zürich, Switzerland.
authors.forename: N H
authors.initials: NH
authors.lastname: Ulrich
authors.affiliation: Department of Orthopedics, Spine Center, University Hospital Balgrist, University of Zurich, Forchstrasse 340, 8008 Zürich, Switzerland.
authors.forename: K
authors.initials: K
authors.lastname: Min
authors.affiliation: Department of Orthopedics, Spine Center, University Hospital Balgrist, University of Zurich, Forchstrasse 340, 8008 Zürich, Switzerland.
authors.forename: C M
authors.initials: CM
authors.lastname: Woernle
mesh_terms: D000328:Adult; D000368:Aged; D017586:Diskectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Lumbar disc herniation; Micro-discectomy; Neurosurgery; Orthopedics; Spine