Evidence map›Paper›PMID 41666858›Full record

ArticleNeurospine2026

International Practice Patterns in the Surgical Management of Primary Lumbar Disc Herniation: An AO Spine Cross-Sectional Study.

Luca Ambrosio, Sathish Muthu, Patrick C Hsieh, S Tim Yoon, Jeffrey C Wang, Gianluca Vadalà, Hans Jörg Meisel, Stipe Ćorluka, Zorica Buser, AO Spine Knowledge Forum Degenerative

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurospine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Luca AmbrosioOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Sathish MuthuDepartment of Orthopaedics, Government Medical College, Karur, India.
Patrick C HsiehUSC Spine Center, Department of Neurological Surgery and Orthopaedics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
S Tim YoonDepartment of Orthopaedics, Emory University, Atlanta, GA, USA.
Jeffrey C WangUSC Spine Center, Department of Neurological Surgery and Orthopaedics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Gianluca VadalàOperative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Hans Jörg MeiselDepartment of Neurosurgery, BG Klinikum Bergmannstrost Halle, Halle, Germany.
Stipe ĆorlukaSpinal Surgery Division, Department of Traumatology, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia.
Zorica BuserGerling Institute, New York, NY, USA.
AO Spine Knowledge Forum Degenerative

Funding

AO SpineAO Spine Knowledge Forum Degenerative
6 · The paper itself

Abstract

objectiveThis study aimed to characterize international practice patterns in the surgical management of primary lumbar disc herniation (LDH) among AO Spine surgeons.

methodsA cross-sectional online survey was distributed in September 2024 to AO Spine members. The questionnaire collected detailed information on demographic characteristics, surgical indications, preferred techniques, and approaches for primary LDH treatment. Data on specialty, practice setting, fellowship training, and surgical case volume were analyzed using univariate and multivariate logistic regression to identify significant associations between surgeon characteristics and treatment preferences.

resultsA total of 714 surgeons participated, representing diverse regions: North America (9.0%), Latin America (18.7%), Europe & Southern Africa (34.7%), Middle East & Northern Africa (12.8%), and Asia Pacific (24.8%). Neurological status was the most critical factor influencing early operative treatment in nonurgent cases, while bladder/bowel dysfunction and severe motor deficits were the primary indications in urgent scenarios. The majority of respondents (54.2%) preferred a mini-open technique-using either a surgical microscope or loupes-with partial laminotomy (58.1%) and partial discectomy (63.2%) being the most frequently performed procedures. Regional variations and differences in surgeon training were significantly associated with the choice of surgical approach and overall case volume.

conclusionThe findings reveal substantial variability in the surgical management of primary LDH across regions and specialties. This comprehensive dataset underscores the need for standardized, evidence-based guidelines to harmonize treatment strategies and optimize patient outcomes.

Indexed as

DiscectomyLumbar disc herniationSequestrectomySpineSurgerySurvey

Identifiers

PMID41666858
PMCPMC12890315

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.