Lateral lumbar disc herniations treated with a paraspinal approach: an independent assessment of longer-term outcomes.

In this independent review, at an average of 5.5 years after surgical excision of a lateral zone disc herniation using a paraspinal approach, 51 of 60 patients (85%) were satisfied with the results. Pain was eliminated in 36 (60%) and reduced in all but 3 (5%). Two-thirds of patients had no residual weakness or numbness. Thirty patients (50%) developed some new low-grade back pain, 17 (28%) developed some radicular pain, 9 (19%) developed some degree of radiographic instability, and 9 (15%) required further operative procedures. Based on this information, surgeons should be able to provide realistic expectations for their patients regarding outcomes. Based on our review of the literature, results using the paraspinal window appear similar, but not superior, to other available techniques, and the choice of approach should be based on the comfort of the surgeon.