The authors describe a microsurgical technique for the preservation of the ligamentum flavum and the long-term surgery-related results, including an independent assessment of outcome.
Three hundred seventy-seven patients underwent ligament-sparing microsurgical discectomy for a previously untreated single-level lumbar disc herniation and were followed for more than 2 years. A successful outcome at 6 months was demonstrated in 93.9% of the patients. At a median follow-up period of 30 months, successful patient-assessed outcome was 84.1%. During the mean follow-up period of 4.2 years (range 2–6.5 years), recurrent disc herniation was detected in 18 patients (4.8%). These patients all underwent repeated surgery. The overall surgery-related rate of complications was 1.3%.
The authors conclude that ligament-sparing microdiscectomy is a safe procedure, with a favorable success rate and minimal morbidity. Reoperation is safer and easier when using this technique compared with traditional ones.