脊椎ジャーナル

Lumbar Herniated Disc Treated by Microdiscectomy Alone or Microdiscectomy Plus an Interlaminar Shock Absorbing Device: Retrospective Study with Minimum 3-Years Follow-Up

Abstract

Olga Valeria Corriero, Riccardo Morichi, Alessandro Vagaggini, Lorenzo Paoli and Giancarlo Guizzardi

Introduction: The long-term results after surgery for symptomatic lumbar herniated disc have been found to have a low success rate in about one third of patients (30% to 40% according to different Authors) who report low back pain rather uncomfortable and restrictive. Nevertheless the long-term results have been scarcely investigated. The aim of this paper is to investigate the long-term results after surgery for lumbar herniated disc in two groups of patients receiving different surgical treatments.

Material and method: A retrospective study has been performed, on a series of 89 consecutive patients, affected by lumbar herniated disc, receiving different surgical treatments: a simple microdiscectomy (Group A: 45 cases) or a microdiscectomy associated with the implantation of an interlaminar prosthesis (Group B:44 cases). General and clinical data resulted homogeneously distributed in both Study Groups.

Results: The follow-up ranged from 3 to 5 years. An independent observer was able to evaluate all patients but one, out of the Group B, who resulted lost to follow-up. Two recurrences resulted in Group A (4,4%) and 1 in Group B (2,2%). The comparison between the 2 Study Groups showed the absence of low back pain during the follow-up period in 74% of patients who received the implant while patients treated by means of simple standard microdiscectomy remained pain free only in 41%. Furthermore uncomfortable low back pain was registered in 21% of patients of Group B against 51% out of Group A. As regards to Macnab Criteria evaluation, that expresses the Quality of Life, 71% of patients resulted Excellent and 22% Good in the Group B, while in the Group A 40% were Excellent and 20% Good. In both groups no poor results were observed.

Conclusion: The number of patients included in this experience is limited and there is a need for a larger series to confirm observations and results, nevertheless we can affirm the goodness of the path undertaken.