Very long-term outcomes of single-level minimally invasive tubular lumbar microdiscectomy with over 10 years follow-up.

Abstract

PURPOSE: Minimally invasive tubular microdiscectomy is an effective treatment for lumbar radiculopathy with similar outcomes compared to open approaches based on short and mid-term data. This study examines patient-reported outcomes (PROMs) after minimally invasive tubular microdiscectomy with > 10 years of follow-up. METHODS: Consecutive patients who underwent tubular microdiscectomy for lumbar disc herniation from May 1, 2010, to July 31, 2013 by a single surgeon at our institution were retrospectively reviewed. We measured VAS leg, VAS back, Oswestry Disability Index (ODI), EQ-5D-3 L and EQ-VAS scores as well as achievement of minimal clinically important difference (MCID). Multivariate analysis was conducted to assess factors associated with outcome measures and reoperation. RESULTS: 103 patients were included, with a mean age of 52.0 ± 14.9 years, and 52 (50.5%) were female. Patients were assessed at baseline, short-term (6 weeks), long-term (3.8 ± 1.2 years), and very long-term (11.6 ± 1.4 years) follow-up. All PROMs improved significantly after surgery and continued to improve with longer periods of follow-up (p < 0.01). The 10-year reoperation rate was 8.7%. Multivariate analysis showed Worker's Compensation Board status to be associated with worse outcomes at short-term follow-up and BMI > 30 to be associated with increased reoperation. CONCLUSIONS: We found continued improvement in PROMs after tubular microdiscectomy with > 10 years follow-up. Tubular lumbar microdiscectomy is a procedure with minimal risk, low revision rate, and lasting clinical benefit after more than a decade.