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Clinical outcomes after lumbar spine microdiscectomy: a 5-year follow-up prospective study in 100 patients

  • Original Article • SPINE - MICROSURGERY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

To evaluate the effect of lumbar microdiscectomy (LM) in pain, disability and quality of life in a 5-year period and to identify potential demographic and clinical risk factors.

Methods

One hundred patients who underwent LM by the same surgeon participated in this prospective study. Clinical assessment was made with validated questionnaires preoperatively and up to 5 years postoperatively. Subsequently, associations between clinical outcomes and demographic data were recorded.

Results

In every assessment questionnaire, there was a significant improvement in the first postoperative month, which lasted up to 1 year post-discectomy. After that, improvement was statistically significant (p < 0.05) but without clinical importance. Women reported more pain preoperatively and 1 month after surgery. Urban residents also presented more pain preoperatively. Older patients had more pain, disability and worse quality of life 1–5 years postoperatively. Similarly, patients with lower education presented the worst scores in every questionnaire at the same time. Smokers reported less pain 1.5–4 postoperative years. Higher alcohol consumption and obesity were associated with lower levels of preoperative pain. However, obese patients had worse SF-36 and ODI scores after the 6th postoperative month. Patients with heavy jobs presented the worst preoperative ODI scores.

Conclusion

Significant clinical improvement was recorded from the first postoperative month to the first postoperative year; stabilization was noticed later on. Feminine gender, urban residency, older age, low level of education, obesity and heavy physical occupation were negative prognostic factors. Oddly smoking and alcohol were correlated with less pain.

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Abbreviations

AUDIT:

Alcohol Use Disorders Identification Test

BMI:

Body mass index

LDH:

Lumbar disc herniation

LM:

Lumbar microdiscectomy

MC:

Modic changes

MRI:

Magnetic resonance imaging

ODI:

Oswestry Disability Index

RMDQ:

Roland Morris Disability Questionnaire

SD:

Standard deviation

SPORT:

Spine Patient Outcomes Research Trial

SPSS:

Statistical Package for Social Sciences

VAS:

Visual analogue scale

WHO:

World Health Organization

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Stavrou Niarchou Anenue, 45500, Ioannina, Greece

    Ioannis D. Gelalis, Evangelos I. Papanastasiou, Emilios E. Pakos, Dimitrios Papadopoulos, Maria Mantzari, Ioannis S. Gkiatas, Marios D. Vekris & Anastasios V. Korompilias

  2. Physical Medicine and Rehabilitation Clinic, University of Ioannina Medical School, Ioannina, Greece

    Avraam Ploumis

  3. Larissa, 41335, Greece

    Evangelos I. Papanastasiou

Authors
  1. Ioannis D. Gelalis
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  2. Evangelos I. Papanastasiou
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Correspondence to Evangelos I. Papanastasiou.

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Conflict of interest

Authors Ioannis D Gelalis, Evangelos I Papanastasiou, Emilios E Pakos, Avraam Ploumis, Dimitrios V Papadopoulos, Maria Mantzari, Ioannis S. Gkiatas, Marios D. Vekris and Anastasios V. Korompilias declare that they do not have any conflict of interest.

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Gelalis, I.D., Papanastasiou, E.I., Pakos, E.E. et al. Clinical outcomes after lumbar spine microdiscectomy: a 5-year follow-up prospective study in 100 patients. Eur J Orthop Surg Traumatol 29, 321–327 (2019). https://doi.org/10.1007/s00590-018-2359-8

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  • DOI: https://doi.org/10.1007/s00590-018-2359-8

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