Ahmadi SA, et al. - This study determined multidimensional long-term outcomes following mono-segmental microdiscectomy for lumbar disc herniation (LDH) in a large adult cohort treated at a tertiary care centre. According to findings, early surgical treatments afforded better outcomes. It was considered important to set time limits for conservative treatments in order to avoid pain chronification and worsening of overall outcomes that go along with belated surgery. Good outcomes were commonly attained in those with acute onset of pain, sequestered herniations and only mild degrees of immobilization and for these subjects, surgical treatment appeared best if indicated early.

Methods

• Researchers performed a retrospective study on all patients undergoing surgical treatment for single-level LDH between 2003 and 2009 and, employed Oswestry Disability Index (ODI) questionnaire at follow-up.
• They analyzed electronic patient records and imaging data.

Results

• At researchers' institution, a total of 939 patients underwent single-level lumbar MD.
• Data showed that 307 complete ODI forms (32.7%) were returned at a median follow-up of 48 months.
• Mean ODI score was 24.04, and mean age was 58 years.
• Researchers found that females reported slightly higher ODI scores (25.52 vs. 22.68).
• They also observed that age and ODI score showed a statistically significant correlation.
• In addition, findings demonstrated that early surgery yielded lower ODI scores with patients faring significantly worse if symptoms persisted for a year or longer (one-way ANOVA,p < 0.001).
• Even among those operated later than 1 week after symptom onset, a sharp increase in ODI scores was evident.
• It was also noted that sequestered herniations were associated with significantly lower ODI scores than contained discs on MRI (21.96 vs. 39.89).
• As per results, surgical complications occurred in 17 cases (5.6%), 82 patients (26.7%) required additional surgery, 58 (18.9%) of those for recurrent disc herniations./li>