Comparison of the Results of Microsurgical Techniques in Lumbar Disc Herniation: A Retrospective Analysis.

[BACKGROUND] When surgical intervention is required for lumbar disc herniation, microdiscectomy is frequently employed. Although sequestrectomy has been compared in several aspects, there is limited evidence regarding clinical outcomes. In this study, we aimed to analyze the clinical effectiveness of both techniques by focusing on their postoperative results.

[AIMS] This study aims to compare the clinical outcomes of sequestrectomy and microdiscectomy with sequestrectomy in patients with single-level lumbar disc herniation, focusing on postoperative pain relief and functional recovery.

[METHODS] A total of 110 patients of any age or gender who had been surgically treated in our clinic for clinically and radiologically confirmed single-level lumbar disc herniation were included. Patients were recorded as having undergone sequestrectomy or discectomy with sequestrectomy, with no significant missing data in preoperative imaging and epicrisis documents. Patients with stabilization procedures, previous surgical history at the same level, or those who had undergone far lateral discectomy were excluded. Postoperative clinical outcomes were analyzed according to the surgical methods employed.

[RESULTS] In patients who underwent sequestrectomy and those who received microsurgical combined sequestrectomy, the postoperative leg pain visual analog scale scores were determined to be 2.51 ± 0.73 (median: 2.00) and 2.38 ± 0.63 (median: 2.00), respectively. No significant difference was observed between the groups (t: 1.01; P: 0.32). Both groups exhibited a statistically significant decrease in leg pain over time. The Cohen's d value in the sequestrectomy group was higher than that in the microsurgical group, indicating a greater effect size for pain reduction over time in the sequestrectomy cohort.

[CONCLUSIONS] Our study suggests that patients undergoing sequestrectomy achieve better pain control over time, particularly in terms of radiculopathy. We believe that sequestrectomy may be more appropriate for younger patients to preserve disc height and tissue.