Introduction: It remains unknown whether aggressive microdiscectomy versus sequestrectomy with little disc invasion provides a better outcome for the treatment of lumbar disc herniation with radiculopathy.
Methods: Patients operated for lumbar disc herniation are grouped in two, where 85 patients who underwent agressive discectomy (AD) are Group A and 40 patients who were operated with sequestrectomy (S) technique are Group B. The patients are chosen among a group that was operated by the same surgeon with two different techniques between 2003 and 2008. The demographic characteristics are similar.
Results: The mean age of patients in Group A is 41.1 (18-74) and that of Group B is 39.9 (22-69). during the postoperative first 10 days, the VAS score for back was 4,1 in Group A and 2,1 in Group B and the difference was statistically significant (p < 0,005). ODI scores were 11 % in Group A and 19 % in Group B in the last examination. Reherniation rate was found to be 1,5 % in Group A and 4,1 % in Group B (p < 0,005). The decrease in the height of the intervertebral disc in 5 years was found to be 32 % in Group A and 20 in Group B; the measurement of the foramina showed a mean decrease of 5% in height ( 3.5-8 % ) which had no clinical significance though being statistically significant ( p=0.06 ).
Conclusions: In summary, we argue that reherniation rates are much lower in long term follow-up when aggressive discectomy technique is used with microdiscectomy. Aggressive microdiscectomy ( AD) disturbs back comfort for a short time but does not change the quality of life. This study is the first study with very long term follow-up showing that reherniations are three times less in aggressive discectomy when compared with sequestrectomy(S).
Patient Care: Clinical and radiological in our enstituies
Learning Objectives: It remains unknown whether aggressive microdiscectomy versus sequestrectomy with little disc invasion provides a better outcome for the treatment of lumbar disc herniation with radiculopathy.