Clinical assessment of reformed lumbar microdiscectomy

The aim of this study was to evaluate the clinical outcomes of the reformed lumbar microdiscectomy preserving more ligamentum flavum than the traditional microdiscectomy does. A prospective, randomized, controlled clinical study was conducted. Patients with unilateral lumbar disc herniation were randomly divided into two groups. The control group underwent traditional lumbar microdiscectomy, and the test group patients underwent the same procedure but with a curved incision of the lumbodorsal fascia and with more preservation of the ligamentum flavum. Visual analogue scale (VAS) scores and Oswestry scale scores were used to appraise the outcomes. Both groups’ clinical parameters were significantly improved after the operation. The VAS scores in the test group showed a less intensity than that in the control group at 3 days, 12 weeks after the operation ( P < 0.05), while at 1 year, showed no significant difference. Both groups’ postoperative leg pain was significantly relieved ( P < 0.05). The VAS scores for leg pain had no significant difference between the two groups at any testing time point after the surgery ( P > 0.05). The Oswestry scale scores showed a better lumbar function state in the test group than that in the control group at 12 weeks and 1 year after the operation ( P < 0.05). In both groups, there was no patient who had a lumbar disc reherniation. Preserving more ligamentum flavum is helpful to improve the clinical outcomes, and this improvement maybe resulted from the prevention of the fibrosis-related complication and the stability of the spine.