gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Two-year clinical outcome following lumbar microdiscectomy versus sequestrectomy

Evaluation des klinischen Outcome nach Mikrodiskektomie versus Sequestrektomie

Meeting Abstract

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  • corresponding author M. Barth - Neurochirurgische Klinik, Universitätsklinikum Mannheim
  • C. Weiss - Institut für medizinische Statistik, Universitätsklinikum Mannheim
  • C. Thome - Neurochirurgische Klinik, Universitätsklinikum Mannheim

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.03.02

The electronic version of this article is the complete one and can be found online at:

Published: April 11, 2007

© 2007 Barth et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Simple fragment excision in cases of herniated lumbar discs has been repeatedly reported as an alternative to standard microdiscectomy, but prospective clinical data with sufficient follow-up is lacking to date. The aim of the present study was to provide a two-year outcome comparison of microdiscectomy (D) versus sequestrectomy (S) in terms of reherniation rates, clinical investigation, and self-rated parameters using a comprehensive questionnaire.

Methods: 84 patients with lumbar disc herniations were treated with microdiscectomy or sequestrectomy in equal parts. Patients were reevaluated thoroughly clinically after 2 years. Results of this investigation (low back pain, sciatica, motor-, sensory-, reflex-, straight leg raising test-indices) and self-rated parameters including SF-36 were analyzed for differences between groups and between time points.

Results: 35 (D) and 38 (S) patients were attainable for clinical follow-up. Reherniation rates did not differ between groups. Following postoperative improvement in both groups, self-rated assessment demonstrated clinical deterioration of the surgical results within the first 2 years after microdiscectomy, while they improved after sequestrectomy. Favorable outcome was achieved in 97.4% after sequestrectomy and in 88.6% after microdiscectomy (p<0.05). 42.9% of microdiscectomy patients needed analgesics 2 years after surgery compared to 21.1% after sequestrectomy (p<0.05).

Conclusions: Reherniation rates within 2 years after sequestrectomy and microdiscectomy are comparable. However, outcome after microdiscectomy seems to worsen over time, while it remains stable after sequestrectomy. Thus, two-year follow-up revealed clinical results favoring sequestrectomy. Performing sequestrectomy alone may therefore represent an advantageous alternative to standard microdiscectomy.