DECOMPRESSION WITH INSTRUMENTATION IN THE TREATMENT OF UPPER-LEVEL DISC HERNIATIONS.

Objective: The aim of this study was to compare the results of microdiskectomy + fusion and microdiskectomy + dynamic instrumentation, which are 2 different methods used for treating upper-level lumbar disk herniations, and to share the data obtained with our colleagues. Materials and Methods: In this study, 51 patients who underwent surgery for upper-level disk herniation between 2019 and 2021 were retrospectively analyzed. The study group was divided into two groups. Patients who underwent microdiscectomy with fusion and those who underwent microdiscectomy with dynamic instrumentation were examined. In both groups, demographic data, such as age and gender, as well as quality of life scores, such as preoperative visual pain scoring and Oswestry disability index, etc. were examined and compared with the postoperative values at the end of 1 year. Complications were noted. Results: There was no significant difference between both groups in terms of gender and age distribution (p=0.676, p=0.992). After 1 year of follow-up, both groups showed significant improvement in both the back-leg visual pain score and Oswestry disability values. When back-leg visual pain and Oswestry disability score change between the groups were analyzed, there was no significant difference in terms of pain, whereas Oswestry disability change was better in the fusion group (p=0.76, p=0.354, p=0.037 respectively). Complications were observed in 7 (13.7%) patients, and superficial wound infection was the most common complication in five (71.4%) patients. Dural tears and hematomas were detected in one patient each. None of the patients required revision surgery. Conclusion: Both techniques can be used for treating upper-level disk herniations. After one year of follow-up, we believe that there is no significant difference between the two groups, although the fusion group appears to be superior in terms of ODI recovery. [ABSTRACT FROM AUTHOR]