• To evaluate the 25 year outcome of discectomy for lumbar disc herniation by validated instruments.

This paper is a retrospective review on 348 consecutive patients who had lumbar discectomy surgery between 1973 and 1979 by the orthopedic department of Federico II Hospital in Naples, Italy.   Seven different surgeons participated in the surgical treatments.   Two Hundred One (201)  patients agreed to participate in follow-up,  either by mail or by an in person evaluation.

The indications for surgical management included failure of at least 6 weeks of non-surgical care and loss of neurologic deficit. This study included a minimum of 25 years of follow-up from the time of surgery.

Post surgery SF-36 and ODI scores were collected. The results were compared to published aggregated data to draw conclusions.

The paper supports the benefit of lumbar discectomy surgery, even 25 years after surgery.

The data provided the results of lumbar discectomy for this population. Statistics such as reoperation rates, satisfaction,  return to activities were also collected and reported. Since only 201 out of 348 patients (57.8%) completed  follow-up there is concern for attrition bias which would could obscure the overall outcome of this study.

While the benefit of this study is an extended follow-up period of 25 years in duration, unfortunately, the conclusions regarding the advantage of surgery versus non-surgical treatment cannot be drawn as there was no corresponding control group from the 1973-1979 time period.