SwissDisc Registry (SDR) – The Register of Patients undergoing Surgical Treatment of lumbar Disc Herniation in Switzerland

Background: Microsurgical discectomy is the gold standard for patients who failed conservative treatment. Although discectomy is perceived to be successful, there is a high failure rate, resulting either from a recurrent disc herniation or chronic and progressive back pain. The treating surgeon must decide intraoperative whether he is seeking an aggressive or conservative removal of intervertebral disc material.

Aims: We introduce a national register for patients undergoing surgical treatment of lumbar disc herniation in Switzerland – the SwissDisc Registry. The aim of the register is to record data of patients who have been operated due to a herniated disc. Thus, a quality control can be performed and the long term outcome of these patients can be observed and compared throughout the country. The Register enables the documentation of recurrent disc herniations, reoperation rates, clinical and radiological characteristics. The collected data, which includes preoperative, intraoperative, and follow-up by 1 and 12 months after surgery documentation, will help to identify influencing factors for recurrence and outcome. The data are collected in an electronic data capture system (REDCap) and accessible for all contributors. SDR was approved by the ethical committee (EKNZ Nr. 2015–124).

Methods: Data collection in SDR is open to all spinal surgeons and Institutions in Switzerland. All patients undergoing surgical treatment of disc herniation in Switzerland are eligible for the SDR. We focus on preoperative history, including risk factors. Radiological preoperative documentation includes MRI and functional x-rays. Intraoperative steps are standardized assessed which include defect size and amount of removed disc material measurement. Postoperatively, a clinical follow-up is scheduled after 3–4 weeks and 1 year after surgery. MRI and x-rays are required at 1-year-follow-up. SDR was introduced in the Department of Neurosurgery at the Kantonsspital Aarau in 2015. So far, data of 200 patients were collected.

Conclusion: The SwissDisc Registry will contribute to reinforce surgical indications and assessment of outcome of patients undergoing treatment of disc herniation throughout a network of spinal surgeons in Switzerland. The SDR will allow an objective evaluation of health policies in these patients and standards in surgical treatment. Spinal surgeons, neurosurgical and orthopedic departments in Switzerland are welcome to join the registry (www.swissdisc.com).