Swiss Disc Registry Update 2018

Aim: The SwissDisc Registry (SDR), a nationwide register of patients undergoing lumbar discectomy, was introduced in Aarau in 2016 and presented at the SSNS congress last year. SDR is open for all spine surgeons performing microsurgical lumbar discectomy (LMD). The aim of the SDR is the identification of risk factors for developing degenerative disc herniation (DDD) in Switzerland, as well as the evaluation of postoperative outcome to assess the risk of reherniation. Ongoing results of the SDR are presented.

Methods and Results: All patients undergoing LMD in Switzerland who failed conservative treatment are eligible for the SDR. So far, a total of 363 patients (193 men, 170 women) with a median age of 51 years were enrolled. A total of 151 (42%) and 51 (14%) patients have a smoking history or were actively smokers prior to LMD. An improvement in documentation since the introduction of SDR in 2016 (n = 161) compared with 2017/18 (n = 199) was observed as follows: preoperative Oswestry Disability Index (ODI) 10% (32% vs 42%), postoperative ODI 16% (30% vs 46%), preoperative documentation sheet (93% to 95%), and postoperative documentation sheet (98% to 78%). A total of 40 patients are ongoing and did not underwent postoperative F/U consultation. Intraoperative documentation was achieved in 100 (100%) patients by 2017/18, as being the control group. Postoperative pain improvement was observed: Back pain 3.6 ± 2.8 (n = 290) versus 2.2 ± 1.9 (n = 105); left leg pain 2.8 ± 2.6 (n = 55) versus 1.6 ± 2.8 (n = 104); right leg 4.1 ± 3.2 (n = 139) versus 1.3 ± 2.1 (n = 105). So far, similar disability indexes (ODI) after LMD were observed: 32.7 ± 23.3 (n = 297) versus 36.7 ± 24.3(n = 76). The incidence of early or late reoperation was 11.5% (n = 42) and reoperation due to early or late reherniation was 11.2% (n = 41).

Conclusions: Since the introduction of the SDR in 2016, a significant improvement in accountability of clinical and radiological documentation was achieved. The SDR documented a relatively high number of reoperation and reherniation due to DDD which still might be underestimated in the clinical practice. SDR will allow an assessment of demographic, clinical, and radiological factors influencing the long-term outcome after LMD in patients suffering lumbar DDD. We invite the Swiss spine surgical community to join the SDR (www.swissdisc.com).