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Similar outcomes seen in patients with lateral or paracentral disc herniation after lumbar microdiscectomy
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LAS VEGAS — Significantly lower SF-12 and Veterans Rand 12-Item mental and physical scores were seen in patients with far lateral herniated nucleus pulposus compared to patients with central or paracentral herniation, according to a presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. However, both groups had similar outcomes 2 years after lumbar microdiscectomy.
“Far lateral [herniated nucleus pulposus] HNPs did have worse preoperative mental [and] physical status compared to the central HNP,” Bryce A. Basques, MD, said during his presentation. “However, despite this worse preoperative status, [patients with] far lateral HNP seem to do similarly well to the central disc herniation [group].”
Researchers performed a retrospective study of 212 patients who underwent a primary lumbar microdiscectomy between 2009 and 2015 for lumbar spinal stenosis. The average follow-up was 24.14 months. Based on the HNP location, 191 patients had central or paracentral disc herniation and 21 patients had the far lateral disc herniation. The patient-reported outcomes collected included Oswestry Disability Index (ODI) scores, VAS scores for back and leg, SF-12 mental and physical scores and the Veterans Rand 12-Item Health Mental and Physical Survey. Clinical outcomes between procedure groups were compared with bivariate and multivariate regressions, and baseline patient characteristics were controlled with multivariate analysis.
A shorter duration of symptoms prior to surgery was seen in patients with far lateral disc herniation. Results from multivariate analysis showed significantly lower SF-12 mental and physical scores and VR-12 mental and physical scores in patients with far lateral disc herniation. After surgery, all patients had comparable SF-12 and VR-12 survey scores. Patients with a far lateral disc herniation had a significantly lower improvement in the ODI score. Reoperation rates were not significantly different between groups. – by Monica Jaramillo
Reference:
Basques BA, et al. Abstract 447. Presented at: the American Academy of Orthopaedic Surgeons Annual Meeting; March 12-16, 2019; Las Vegas.
Disclosure: Basques reports no relevant financial disclosures.