• World Neurosurg · Sep 2018

    Case Reports

    Is a Unilateral Surgical Approach Effective in Patients with Bilateral Leg Pain with Unilateral Lumbar Disc Herniation? A Prospective Nonrandomized Clinical and Surgical Study.

    • Ihsan Dogan, Melih Bozkurt, Gokmen Kahilogullari, Fatih Yakar, Murat Zaimoglu, Batuhan Bakirarar, Cihan Kircil, Umit Eroglu, Onur Ozgural, Melih Ucer, Cemil Kilinc, Altan Demirel, Efe Guner, Hasan Caglar Ugur, and Yusuf Sukru Caglar.
    • Department of Neurosurgery, Ankara University, School of Medicine, Ibni Sina Hospital, Ankara, Turkey. Electronic address: ihsandogan@ankara.edu.tr.
    • World Neurosurg. 2018 Sep 1; 117: e316-e322.

    ObjectiveTo examine the surgical results of unilateral lumbar discectomy in patients with bilateral leg pain and discuss short- and long-term outcomes within the limits of lumbar decompression.MethodsWe analyzed 60 patients with unilateral disc herniation who underwent unilateral lumbar discectomy and hemipartial laminectomy between 2014 and 2017. Group 1 (30 patients) had bilateral leg pain and unilateral lumbar disc herniation. Pain lateralization was determined radiologically. Group 2 (30 patients) had unilateral leg pain and unilateral lumbar disc herniation. Pain scores were preoperatively evaluated with visual analog scale (VAS) for both legs and Oswestry Disability Index (ODI) for overall life quality. In both groups, surgery was performed on the ipsilateral side of the herniated disc. Scores were repeated on postoperative day 1 and 1, 3, 6, 12, and 24 months later. VAS score differences for pain lateralization and disc levels were compared in group 1. ODI score differences were compared between both groups. Results were statistically analyzed.ResultsVAS score differences were statistically significant at all follow-up time points in patients with ipsilateral and contralateral pain. VAS score differences between L4-L5 and L5-S1 level discopathies were statistically insignificant for all time points in both groups. All postoperative ODI score decreases for all time points were statistically significant (P < 0.001) for both groups, whereas the differences between groups 1 and 2 were statistically insignificant.ConclusionsConventional lumbar disc surgery alone is sufficient for the ipsilateral side of radiologically demonstrated disc herniation in patients with bilateral leg pain.Copyright © 2018 Elsevier Inc. All rights reserved.

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