Surgery for lumbar disc herniation: Analysis of 500 consecutive patients treated in an interdisciplinary spine centre

• The clinical outcome after surgery for lumbar disc herniation with a microsurgical approach is similar to the open procedure.
• No differences regarding complications between a microdiscectomy versus open sequestrectomy and discectomy have been shown.
• These results strengthen the importance of an interdisciplinary training concept of spine surgeons in their residency.

Surgical removal of a symptomatic herniated lumbar disc is performed either with or without the support of a microscope. Up to the time of writing, the literature has reported similar clinical outcomes for the two procedures. Five hundred consecutive patients, operated upon for primary single-level lumbar disc herniation in our University Spine Center between 2003–2011, with (n = 275), or without (n = 225), the aid of a microscope were included. Data were retrospectively analyzed, comparing the primary endpoint of clinical outcome and the secondary endpoints of complications, surgical time and length of hospitalization. Clinical outcomes and reoperation rates were comparable in both groups. Surgical time was significantly shorter with a mean time of 47 minutes without use of the microscope compared to the mean time of 87 minutes (p < 0.001) with the use of the microscope. Mean length of hospitalization was shorter in those operated with the microscope (5.3 days) compared to those without (6.1 days, p = 0.004). There was no difference in rates of complications. Microdiscectomy versus open sequestrectomy and discectomy for surgical treatment of lumbar disc herniation is associated with similar clinical outcomes and reoperation rates. Open sequestrectomy is associated with shorter operation times. Microdiscectomy is associated with shorter hospitalization stays.