Outcomes of lumbar decompression microsurgery

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Seliverstova E.G.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0001-9652-1457

Sinkin M.V.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0001-5026-0060

Kordonsky A.Yu.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0001-5344-3970

Zabolotnikova D.A.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0003-3515-8329

Grin A.A.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0003-3515-8329

Outcomes of lumbar decompression microsurgery

Authors:

Seliverstova E.G., Sinkin M.V., Kordonsky A.Yu., Zabolotnikova D.A., Grin A.A.

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Journal: Burdenko's Journal of Neurosurgery. 2023;87(3): 47‑55

DOI: 10.17116/neiro20238703147

Views: 3250

Downloaded: 58

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To cite this article:

Seliverstova EG, Sinkin MV, Kordonsky AYu, Zabolotnikova DA, Grin AA. Outcomes of lumbar decompression microsurgery. Burdenko's Journal of Neurosurgery. 2023;87(3):47‑55. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20238703147

Подписка 2025-2 (Burdenko's Journal of Neurosurgery)

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BACKGROUND

Microsurgical decompression of the spinal root in patients with herniated intervertebral discs is the most common spinal surgery. However, most national and foreign studies devoted to assessment of postoperative outcomes contain no consensus on the timing of radicular pain syndrome relief after decompression and predictors of unfavorable outcomes.

OBJECTIVE

To determine the period of radicular pain syndrome relief after microsurgical decompression and to identify clinical and neuroimaging predictors of unfavorable postoperative outcomes.

MATERIAL AND METHODS

The study included 58 patients aged 26—73 years with clinical manifestations of L5 radiculopathy following compression by L4—L5 herniated disc. We assessed neurological status, functional state (Oswestry Disability Index) and fatty infiltration of paravertebral muscles. Results. Isolated radicular pain was observed in 31% of patients, combination of pain syndrome and sensory disorders — 17%, pain syndrome and motor disorders — 24%, pain syndrome, sensory and motor disorders — 28% of patients. Duration of disease until surgery was significantly longer in women (p=0.030). Complete relief of radicular pain immediately after surgery was observed in 24 (48%) patients. Sixteen (32%) patients had persistent pain syndrome for up to 1 month. Relief of radicular pain on the first postoperative day was significantly more common in patients without motor disorders (p<0.014). The outcomes of microsurgical decompression did not depend on duration of disease (p=0.551), sex (p=0.794), age (p=0.491) and degree of fatty infiltration of paravertebral muscles (p=0.686).

CONCLUSION

Radicular pain regresses within 4 weeks after microsurgical decompression. The predictor of unfavorable postoperative outcomes (long-standing pain syndrome and no functional improvement) is any preoperative motor impairment.

Keywords:

radiculopathy

disc herniation

microdiscectomy

visual analogue scale (VAS)

Authors:

Seliverstova E.G.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0001-9652-1457

Sinkin M.V.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0001-5026-0060

Kordonsky A.Yu.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0001-5344-3970

Zabolotnikova D.A.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0003-3515-8329

Grin A.A.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0003-3515-8329

Received:

29.11.2022

Accepted:

24.03.2023

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