Looking Back on Results of Lumbar DiscectomyLong-term studies of surgery outcomes can help doctors and patients determine if surgery is the best treatment for their needs. Currently, there are few such studies of people who've had standard discectomy surgery for a herniated disc in the low back. This procedure involves shaving the edge of bone that covers the back of the injured disc. Then the surgeon takes out the herniated portions from center of the disc (the nucleus pulposus) and any other fragments of the injured disc. The idea is to remove just enough of the disc to prevent the disc from herniating again.
Researchers conducted this study by contacting 72 patients who'd had this surgery at least 10 years earlier. Nine of the patients also required further surgery, so their data was analyzed separately.
So what kind of results does lumbar discectomy show 10 years down the road? Using a specialized scoring method, the authors calculated a favorable recovery rate (about 74%). Significantly, about 40% of all the patients kept up with their recreational activities, including sports, 10 years after surgery.
Over half the patients reported occasional mild low back pain, but only about 13% said their pain was severe. Of those with severe pain, most were under age 35 and showed greater disc degeneration before surgery. The authors suggest that younger patients may have more active lifestyles compared to older patients, which may explain why they had a lot more pain after surgery. The researchers also compared rates of leg pain. Only 44% of patients had no remaining leg pain or tingling, and about 10% experienced occasional severe leg pain.
The authors used X-rays at the follow up to measure the height of the injured disc. Discs appear thinner if more of the nucleus spurts out of the disc during the initial herniation, or if the surgeon takes out a larger portion of the nucleus. As it turns out, the patients with greater disc heights had the best results. However, they were also found to have a slightly higher risk of having the disc herniate again. It's a trade-off that should be studied further to help surgeons know how much is too much when removing the nucleus during standard lumbar discectomy.
Etsuro Yorimitsu, MD, et al. Long-Term Outcomes of Standard Discectomy for Lumbar Disc Herniation: A Follow-Up Study of More Than 10 Years. In Spine. March 15, 2001. Vol. 26. No. 6. Pp. 652-657.
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