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

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.