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World Neurosurg. 2010 Jun;73(6):742-6. doi: 10.1016/j.wneu.2010.04.004.

Prediction of the need for an MRI after surgical treatment of symptomatic lumbar herniated disc at discharge: evaluation of the necessity for regular visits at the outpatient clinic.

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Department of Neurosurgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.



Surgical treatment of symptomatic lumbar disc herniations has been well established. The need for regular postoperative visits at the outpatient clinic has never been evaluated. In this study, factors predicting the need for magnetic resonance imaging, denoting an unfavorable outcome needing further evaluation, were evaluated.


The charts of all patients who underwent first surgery for a lumbar herniated disc were evaluated. Predefined factors that could possibly be a predictive factor were collected: gender, age at surgery, level of surgical pathology, profession of the patient, and at discharge: leg pain, back pain, medication used for leg pain, new neurological deficit after the surgical procedure, and the number of days of their postoperative stay at the hospital. The factors were statistically analyzed.


One hundred seventy-two patients were identified. Twenty-nine patients underwent magnetic resonance imaging during their postoperative follow-up. None of the predefined factors at discharge had any predictive value.


The need for a regular appointment at the outpatient clinic for patients who underwent the first surgery can be questioned. Preoperatively and postoperatively, extensive instructions about postoperative issues related to work and lifestyle should be given. By Web or telephone, these patients should complete questionnaires at regular intervals to evaluate to outcome of the surgery. In case of unsuspected events, persistent, or recurrent complaints the patient should visit the clinic or outpatient clinic.

[Indexed for MEDLINE]

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