gms | German Medical Science

Objective: Sequestrectomy alone in cases of herniated lumbar disc disease has been reported as an attractive alternative to standard microdiscectomy. However, prospective long-term data from randomized trials are scarce. The two year-results of the present patient cohort comparing sequestrectomy (S) alone versus discectomy (D) revealed clinical results favouring sequestrectomy.

Method: All patients from our initial trial (n=84) were contacted and invited for an interview with clinical investigation 8 years after initial surgery. Results of this investigation (VAS back, VAS leg, motor-, sensory-, straight leg raising test-indices) and self-rated parameters including ODI were analyzed for differences between groups.

Results: 25 (D) and 28 (S) patients were attainable for personal presentation or for follow-up informations using a questionnaire. Among those patients, the 8-year cumulative rate of the first repetitive surgery did not differ significantly (28.0%, group D; 17.9%, group S; p=0.17). Results of the clinical investigation showed no significant differences between groups. VAS back and leg values at rest and at stress were throughout lower in the S group (not significant), as it was the ODI.

Conclusions: There is a considerable high rate of clinically symptomatic recurrent disc herniation within 8 years after sequestrectomy and discectomy with a trend to be lower in the S group. At the same time, clinical data of the S group 8 years after surgery still remain slightly improved compared to the D group. Therefore, sequestrectomy alone might be the preferred procedure in cases of herniated lumbar disc disease.