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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Microscopic versus open discectomy for lumbar disc herniation: a retrospective single center analysis of 500 consecutive patients

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  • Christoph M. Woernle - Department of Orthopaedics, Division of Spinal Surgery, University Hospital Balgrist, University of Zurich, Zurich, Switzerland
  • Samuel L. Schmid - Department of Orthopaedics, Division of Spinal Surgery, University Hospital Balgrist, University of Zurich, Zurich, Switzerland
  • Harry-Bert Ulrich - Department of Orthopaedics, Division of Spinal Surgery, University Hospital Balgrist, University of Zurich, Zurich, Switzerland
  • Alexander Antoniadis - Department of Orthopaedics, Division of Spinal Surgery, University Hospital Balgrist, University of Zurich, Zurich, Switzerland
  • S. Hirsiger - Department of Orthopaedics, Division of Spinal Surgery, University Hospital Balgrist, University of Zurich, Zurich, Switzerland
  • Gianmarco Colombo - Department of Orthopaedics, Division of Spinal Surgery, University Hospital Balgrist, University of Zurich, Zurich, Switzerland
  • Kan Min - Department of Orthopaedics, Division of Spinal Surgery, University Hospital Balgrist, University of Zurich, Zurich, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 143

doi: 10.3205/14dgnc538, urn:nbn:de:0183-14dgnc5382

Published: May 13, 2014

© 2014 Woernle et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Discectomy for lumbar disc herniation is a common procedure. Different techniques were performed and still controversial under discussion in the literature.

Method: 500 consecutive patients from 2004–2010 were retrospectively analysed after either microscopic or open discectomy for lumbar disc herniation. 225 patients were treated with an open, 275 with a microscopic procedure. Primary endpoints were defined as: clinical outcome, duration of operation time and hospital stay. As secondary endpoint we analysed the cost-effectiveness of both procedures.

Results: Regarding the clinical outcome both procedure were equal in focusing on neurological outcome and recurrent disc herniation. In the open group the average operation time was 46 min (20–90 min) compared to 87min (45–195 min) found in the microscopic discectomy group. Hospitalisation was shorter in the microscopic discectomy group (6.3 days) compared to the open discectomy group (7.2 days). Regarding the cost-effectiveness there was no significant difference of the two groups. The overall cost of open discectomy was 8’903 CHF compared to 9’167 CHF with microscopic discectomy.

Conclusions: In this retrospective single center analyses open vs. microscopic discectomy showed equal results focusing on clinical outcome and cost effectiveness. Further prospective randomized trials were necessary in this regard.