Comparative Study of 2 Skin Incisions for Microscopic Lumbar Discectomy.

OBJECTIVE: Microscopic lumbar discectomy is a common minimally invasive surgery. A transverse skin incision has sound theoretical cosmetic advantages compared with the classic vertical incision. We compared transverse and vertical skin incisions for microscopic discectomy regarding cosmetic outcome, postoperative pain, and the provided surgical cutaneous inlet.

METHODS: This prospective study enrolled 86 patients who were randomly assigned to a vertical incision group or a transverse incision group. The maximum surgical cutaneous inlet provided was measured in 2 diameters. Pain was recorded on postoperative days 1, 3, and 7 using a numeric patient rating scale from 0 to 10 with 0 indicating no pain. The cosmetic appearance of the wound was evaluated by a plastic surgeon and by the patients as excellent, very good, good, fair, and poor.

RESULTS: Compared with vertical incisions, transverse incisions provide similar surgical cutaneous inlets, cause higher pain scores on postoperative days 1 and 3 but a similar score on postoperative day 7, and ensure significantly better wound cosmesis.

CONCLUSIONS: Transverse skin incision for microscopic lumbar discectomy is an applicable alternative to classic midline or paramedian vertical incision with better esthetic results.