Impact of Herniation Level on Surgical Outcome of Microlumbar Discectomy

Introduction: L4-L5 and L5-S1 are the most common sites for lumbar disc herniation (LDH). The aim of this study is to compare preoperative demographic indices and surgical outcomes in them. Materials and Methods: We retrospectively evaluated 280 patients (Male to female: 168 to 112) who underwent simple microlumbar discectomy in our orthopedic department from March 2009 to December 2012 and followed-up for more than two years. Total mean age of the patients was 38.5 ± 11.3 (ranged 19 to 76) years old. We placed them in two groups; A: L5-S1 (128 patients) and B: L4-L5 (152). We assessed them preoperatively and at the last follow-up visit. Statistical significance was assumed as a p<5%. Results: Group B was about 5 years older. Preoperative Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) for leg, and time to operation were significantly higher in group B. At the last follow-up visits, pain scores were comparable but ODI scores in group B remained higher, although mean improvement in ODI score in this group was also higher. Conclusions: The patients with L4-L5 versus L5-S1 LDH have more preoperative leg pain and ODI scores and shorter time to operation, although the ultimate satisfaction rates at final follow-up visit are similar.