Examination of quality of life and economic benefit with early lumbar microdiscectomy: A Pilot Study

Purpose Lumbar microdiscectomy is a surgical intervention which improves radiculopathy with lower back pain and quality of life. The health economic benefit of completing surgery in a timely manner has not been explored in depth. We ask to question is early surgery superior in quality of life when compared to late surgery? Methods A prospective database of patients who met the inclusion criteria was used to garner data on patient waiting times. Telephone interviews were completed detailing various outcome measures of the core outcome measures index (COMI) questionnaire post-operatively. Surgery was early (less than 12 months) or late (more than 12 months). Results Post-operative ‘Sciatica severity’ shows a statistically significantly greater value in sciatica severity among those presenting to surgery greater than one year (score of 3.9) compared to those presenting to surgery less than one year (score of 1.8). ‘Rest of life symptom satisfaction’ shows statistically significant differences between the surgical wait-time groups, with those operated on within one year more likely to be very satisfied than those after one year. Hospital length of stay nears a statistically significant difference for those operated on within one year(median 3 days) compared to those operated on after one year(median 2 days), but this does not reach statistical significance. Conclusion Regardless of cost, it is apparent that patient-related outcomes are superior in candidates operated on within one year. Poorer quality of life outcomes highlight how a successful operative intervention is deemed less effective due to delays outside of the surgeon’s control. Our results highlight that these operations should be completed in a timely manner to ensure the patient is receiving the highest standard of care and minimise the likelihood of representation.