Additive Benefit Analysis of Spinal Discectomy Tissue Specimens

Abstract

Aim: The necessity of performing routine histopathological examinations on intervertebral disc specimens obtained during microdiscectomy remains a matter of debate with limited data available in the current literature. This study aimed to evaluate whether such routine examinations provide additional diagnostic or therapeutic value. Material and Method: A total of 224 intervertebral disc specimens (78 cervical, 146 lumbar) obtained from 190 consecutive patients who underwent surgery for symptomatic disc herniation between 2017 and 2021 were retrospectively analyzed. Clinical, radiological, intraoperative, and histopathological findings were systematically analyzed and compared. Results: The most frequently affected levels were C5–C6 and C6–C7 in the cervical spine, and L4–L5 and L5–S1 in the lumbar spine. A statistically significant difference was observed in the type of herniation between the cervical and lumbar regions (p=0.0005). Histopathological examination revealed degenerative changes in all specimens. In one case, polymorphonuclear cell infiltration was noted; however, there were no supporting clinical or radiological signs suggestive of discitis. In another case, the intraoperative discovery of black disc material led to a diagnosis of alkaptonuria, which was later confirmed by genetic analysis. Conclusion: Routine histopathological examination of intervertebral disc specimens obtained during microdiscectomy did not contribute to diagnosis or treatment planning in our study. Given the low diagnostic yield and additional cost, such evaluations should be reserved for selected cases with specific clinical, radiological, or intraoperative suspicion.

Keywords

• Microdiscectomy
• histopathological examination
• intervertebral disc
• degenerative disc disease
• cost-effectiveness

Kaynakça

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