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The functional relevance of neurological recovery after lumbar discectomy

A FOLLOW-UP OF MORE THAN 20 YEARS

¹ Federico II University Hospital, Via S. Pansini 5, ed. 12, 80131 Napoli, Italy
² Magna Graecia University, Campus S. Venuta, Viale Europa, 88100 Catanzaro, Italy

Correspondence should be sent to Professor M. Mariconda; e-mail: maricond{at}unina.it

We have studied 180 patients (128 men and 52 women) who had undergone lumbar discectomy at a mean of 25.4 years (20 to 32) after operation. Pre-operatively, most patients (70 patients; 38.9%) had abnormal reflexes and/or muscle weakness in the leg (96 patients; 53.3%). At follow-up 42 patients (60%) with abnormal reflexes pre-operatively had fully recovered and 72 (75%) with pre-operative muscle impairment had normal muscle strength. When we looked at patient-reported outcomes, we found that the Short form-36 summary scores were similar to the aged-matched normative values. No disability or minimum disability on the Oswestry disability index was reported by 136 patients (75.6%), and 162 (90%) were satisfied with their operation. The most important predictors of patients’ self-reported positive outcome were male gender and higher educational level. No association was detected between muscle recovery and outcome.

Most patients who had undergone lumbar discectomy had long-lasting neurological recovery. If the motor deficit persists after operation, patients can still expect a long-term satisfactory outcome, provided that they have relief from pain immediately after surgery.

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