Study Design. A retrospective analysis of the outcome of lumbar microd
iscectomy, with independent assessment of outcome. Objectives. To expl
ore whether the initial positive outcome after microdiscectomy is main
tained at longterm follow-up. Summary of Background Data. Previous rep
orts on long-term outcome after lumbar disc surgery give conflicting m
essages about whether an initially positive surgical outcome is mainta
ined throughout a 10-year period. This is partly due to differing meth
ods and the. failure to include initial outcome, thereby permitting as
sessment of possible deterioration in the quality of outcome. Methods.
This study presents the initial and longterm outcome after lumbar mic
rodiscectomy, with an independent assessment of outcome. Eighty-eight
consecutive patients undergoing lumbar microdiscectomy were identified
. Assessment at 10 years after surgery was obtained in 79 (90%) of the
cases. The initial outcome was assessed retrospectively by an indepen
dent observer at 6 months after surgery using the Macnab classificatio
n. The final outcome Macnab classification was completed by postal que
stionnaire by the patients themselves, who also completed a modified R
oland-Morris disability questionnaire. Results. A successful outcome a
t 6 months was achieved in 91% of the cases At 10-year follow-up, this
result declined slightly to an 83% success rate. However, there was n
o statistically significant difference between these outcome results.
The long-term Macnab classification results correlated well with disab
ility, as measured by the Roland-Morris score. Patient satisfaction wi
th the results of microdiscectomy 10 years later was high. Conclusions
. Lumbar microdiscectomy achieves a high level of initial success, and
this positive outcome is maintained at a 10-year follow-up.