• Gustav Østerheden Andersen, Stefan Milosevic, Mads Moss Jensen, Leah Carreon, Casper Friis Pedersen, Mikkel Østerheden Andersen, and Peter Helmig.
• Department of Clinical Medicine-Orthopedic Surgery, Aarhus University Hospital, Aarhus N, Denmark. Electronic address: gustavoesterheden@gmail.com.
• World Neurosurg. 2025 Feb 7; 195: 123641123641.

ObjectiveTo investigate patient-reported outcomes following lumbar discectomy in patients with lateral lumbar disc herniation (LDH) compared with patients with paramedian LDH.MethodsData on patients with lateral and paramedian LDH operated on between 2017 and 2020 at a single public spine unit were extracted from the National Danish Spine Registry, DaneSpine. A propensity score-matched, case-control analysis was conducted to compare the 2 groups. Subgroup analysis was done by further dividing the lateral LDH group into foraminal and extraforaminal groups. Patient demographics, Oswestry Disability Index visual analog scale (VAS) leg and back pain (0-100), EuroQol-5D questionnaire, and measures of patient improvement and satisfaction were collected at baseline and 1 year postoperatively.ResultsOf 887 eligible patients, baseline and 1-year follow-up data were available for 525 patients with paramedian LDH and 68 patients with lateral LDH. Following propensity score matching, the 2 groups were similar in terms of all baseline characteristics (P > 0.05). There were no significant differences between groups in Oswestry Disability Index, VAS leg pain, VAS back pain, and EuroQol-5D 1 year postoperatively. Both groups improved in all outcomes from inclusion to follow-up (P < 0.001). Subgroup analysis showed that patients with foraminal LDH compared with extraforaminal LDH had a significantly greater improvement in VAS leg pain (P = 0.016) with a larger number of patients with clinically significant leg pain improvement (P = 0.03).ConclusionsPatients with lateral and paramedian LDH reported similar postsurgical outcomes. Spine surgeons should be less hesitant to operate on patients with lateral LDH. Patients with extraforaminal LDH experienced the least relief of leg pain.Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.

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