Surgical Outcomes of Lumbar Disc Herniation: A Retrospective Analysis

Background: Lumbar disc herniation (LDH) represents one of the most common spinal disorders requiring surgical intervention. Despite various surgical approaches available, there remains a lack of consensus regarding optimal techniques and their long-term outcomes.

Objective: To evaluate the clinical outcomes, complications, and prognostic factors associated with surgical management of LDH in a large, single-center cohort.

Methods: This retrospective analysis examined 425 consecutive patients who underwent surgical treatment for symptomatic lumbar disc herniation (LDH) between January 2018 and December 2022. Surgical approaches included microdiscectomy, endoscopic discectomy, and open discectomy. The primary outcomes were pain reduction (measured by the Visual Analog Scale), functional improvement (as assessed by the Oswestry Disability Index), and return to work or activities. Secondary outcomes included reoperation rates, complications, and patient satisfaction scores.

Results: At a mean follow-up of 36.7 months, significant improvements were observed in pain scores (mean reduction, 4.2 ± 1.6 points; p < 0.001) and functional capacity (mean ODI improvement, 28.7 ± 11.3 points; p < 0.001) across all surgical modalities. Microdiscectomy demonstrated superior outcomes for selected parameters, including shorter hospital stay, faster return to activities, and lower complication rates compared to open procedures. Recurrent herniation occurred in 7.3% of patients, with higher rates in those with larger disc herniations, obesity, and smoking history. Multiple regression analysis identified younger age, shorter symptom duration, and absence of comorbidities as positive prognostic factors.

Conclusion: Surgical intervention for LDH provides significant and sustained clinical improvement across multiple outcome domains. Minimally invasive approaches appear to offer advantages in terms of early recovery metrics, although long-term functional outcomes were comparable across techniques. Patient selection and consideration of identified prognostic factors may optimize surgical decision-making and outcomes.