Comparative Study of Lumbar Disc Prolapse Surgery With or Without Coagulation: A Report of 2,180 Cases

TL;DR

This study compares lumbar disc surgery with and without coagulation in 2,180 cases, finding no significant difference in patient outcomes.

Contribution

The study presents the largest series to date comparing lumbar disc surgery with and without coagulation.

Findings

Lumbar disc surgery without coagulation is safe and effective.

There is no significant difference in physical or mental health outcomes between groups with or without coagulation.

Coagulation is not obligatory for lumbar microdiscectomy.

Abstract

Lumbar disc prolapse surgery is among the most common neurosurgical procedures performed worldwide. To our knowledge, this is the first report of the largest series comparing prolapsed lumbar disc surgery with and without coagulation. Previous studies have shown that coagulation during surgery may be associated with higher morbidity, particularly in terms of infection rates. This study aims to investigate the necessity of coagulation during lumbar microdiscectomy, specifically whether coagulation is required to control bleeding in the disc space, surrounding ligaments, or other tissues during the procedure.

A total of 2,180 cases were retrospectively analyzed from 2010 to 2020, with a minimum follow-up of two years. The study compared the effect of coagulation on outcomes for lumbar microdiscectomy, specifically evaluating quality of life through the PROMIS (Patient-Reported Outcomes Measurement Information System) score. PROMIS was used to assess both physical and mental health outcomes before and after surgery. The data were collected from a single center.

Patients were divided into two groups: Group 1 (coagulation) and Group 2 (no coagulation). The PROMIS score was obtained preoperatively and postoperatively using the online “ortho-toolkit” questionnaires, and the average scores for both groups were calculated to assess their overall health status. The average preoperative physical health score (PHS T-score) was 32.4 for Group 1 and 31.3 for Group 2. Postoperatively, the scores were 54.1 for Group 1 and 56.2 for Group 2. Similarly, the average preoperative mental health score (MHS T-score) was 41.1 for Group 1 and 39.7 for Group 2, with postoperative scores of 48.3 for Group 1 and 52.8 for Group 2.

Lumbar disc prolapse surgery without coagulation is safe and effective. There is no difference in outcome using coagulation or not in lumbar disc prolapse surgery, and its use is not obligatory.

Figures