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A 10-Year Follow-Up of the Outcome of Lumbar Microdiscectomy

Findlay, Gordon F., FRCS*; Hall, Bruce I., FRCS*; Musa, B. Sele, FRCS*; Oliveira, Mauricio D., MD*; Fear, Simon C., BSc (Hons)

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Study Design. A retrospective analysis of the outcome of lumbar microdiscectomy, with independent assessment of outcome.

Objectives. To explore whether the initial positive outcome after microdiscectomy is maintained at long-term follow-up.

Summary of Background Data. Previous reports on long-term outcome after lumbar disc surgery give conflicting messages about whether an initially positive surgical outcome is maintained throughout a 10-year period. This is partly due to differing methods and the failure to include initial outcome, thereby permitting assessment of possible deterioration in the quality of outcome.

Methods. This study presents the initial and long-term outcome after lumbar microdiscectomy, with an independent assessment of outcome. Eighty-eight consecutive patients undergoing lumbar microdiscectomy were identified. Assessment at 10 years after surgery was obtained in 79 (90%) of the cases. The initial outcome was assessed retrospectively by an independent observer at 6 months after surgery using the Macnab classification. The final outcome Macnab classification was completed by postal questionnaire by the patients themselves, who also completed a modified Roland-Morris disability questionnaire.

Results. A successful outcome at 6 months was achieved in 91% of the cases. At 10-year follow-up, this result declined slightly to an 83% success rate. However, there was no statistically significant difference between these outcome results. The long-term Macnab classification results correlated well with disability, as measured by the Roland-Morris score. Patient satisfaction with the results of microdiscectomy 10 years later was high.

Conclusions. Lumbar microdiscectomy achieves a high level of initial success, and this positive outcome is maintained at a 10-year follow-up.

From the *Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom, and the †Department of Mathematical Sciences (Medical Statistics Unit), University of Liverpool, United Kingdom.

Acknowledgment date: June 30, 1997.

First revision date: December 2, 1997.

Acceptance date: February 2, 1998.

Device status category: 1.

Address reprint requests to: Gordon F. Findlay, FRCS; Walton Centre for Neurology and Neurosurgery; Rice Lane; Liverpool L9 1AE; United Kingdom.

© Lippincott-Raven Publishers.