Lumbar discectomy with lumbar disc implant and its association with quality of life in patients with lumbar disc herniation at a Peruvian military hospital, 2023–2024

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Vilela-Estrada" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Lumbar disc herniation is a frequent cause of low back pain and functional disability in adults, often impairing health-related quality of life. Discectomy with lumbar disc implant is used in selected cases, although its impact on quality-of-life outcomes remains under debate. Objective To determine the association between discectomy with lumbar disc implant and health-related quality of life in adult patients with lumbar disc herniation treated at the Hospital Central de la Fuerza Aérea del Perú between 2023 and 2024. Methods An analytical cross-sectional study was performed using medical record review and the Short Form-36 Health Survey (SF-36) in adult outpatients from Neurosurgery and Physical Medicine and Rehabilitation. Sociodemographic and clinical variables were analyzed using descriptive and analytical methods. Results Ninety-five patients were included; 56 received a lumbar disc implant and 39 did not. Baseline characteristics were comparable between groups. Patients with disc implantation showed higher SF-36 scores, with significant improvements in vitality, emotional role limitations, and mental health. Disc implantation was independently associated with improved quality of life (adjusted PR: 1.68; 95% CI: 1.02–2.79), while age and sex showed no significant association. Conclusions Lumbar discectomy with a lumbar disc implant was independently associated with improved quality of life among patients with lumbar disc herniation, while age and sex showed no significant association with this outcome. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/15-474", "name": "Lumbar discectomy with lumbar disc implant and its association with..." } } ] } Home Browse Lumbar discectomy with lumbar disc implant and its association with... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Nomberto-Orbegoso G, Rodríguez E, Ramírez Espinoza A and Vilela-Estrada MA. Lumbar discectomy with lumbar disc implant and its association with quality of life in patients with lumbar disc herniation at a Peruvian military hospital, 2023–2024 [version 1; peer review: awaiting peer review] . F1000Research 2026, 15 :474 ( https://doi.org/10.12688/f1000research.178759.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Lumbar discectomy with lumbar disc implant and its association with quality of life in patients with lumbar disc herniation at a Peruvian military hospital, 2023–2024 [version 1; peer review: awaiting peer review] Gianfranco Nomberto-Orbegoso https://orcid.org/0009-0000-8853-3458 1 , Ernesto Rodríguez https://orcid.org/0009-0005-0153-0630 1 , Alberto Ramírez Espinoza 2 , Martín A. Vilela-Estrada https://orcid.org/0000-0002-1494-952X 2 Gianfranco Nomberto-Orbegoso https://orcid.org/0009-0000-8853-3458 1 , Ernesto Rodríguez https://orcid.org/0009-0005-0153-0630 1 , Alberto Ramírez Espinoza 2 , Martín A. Vilela-Estrada https://orcid.org/0000-0002-1494-952X 2 PUBLISHED 06 Apr 2026 Author details Author details 1 La Libertad, Universidad Privada Antenor Orrego, Trujillo, Trujillo, 13001, Peru 2 Lima, Instituto Nacional de Salud del Niño San Borja, Lima, Perú, 15037, Peru Gianfranco Nomberto-Orbegoso Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Ernesto Rodríguez Roles: Data Curation, Investigation, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Alberto Ramírez Espinoza Roles: Formal Analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Martín A. Vilela-Estrada Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW Abstract Background Lumbar disc herniation is a frequent cause of low back pain and functional disability in adults, often impairing health-related quality of life. Discectomy with lumbar disc implant is used in selected cases, although its impact on quality-of-life outcomes remains under debate. Objective To determine the association between discectomy with lumbar disc implant and health-related quality of life in adult patients with lumbar disc herniation treated at the Hospital Central de la Fuerza Aérea del Perú between 2023 and 2024. Methods An analytical cross-sectional study was performed using medical record review and the Short Form-36 Health Survey (SF-36) in adult outpatients from Neurosurgery and Physical Medicine and Rehabilitation. Sociodemographic and clinical variables were analyzed using descriptive and analytical methods. Results Ninety-five patients were included; 56 received a lumbar disc implant and 39 did not. Baseline characteristics were comparable between groups. Patients with disc implantation showed higher SF-36 scores, with significant improvements in vitality, emotional role limitations, and mental health. Disc implantation was independently associated with improved quality of life (adjusted PR: 1.68; 95% CI: 1.02–2.79), while age and sex showed no significant association. Conclusions Lumbar discectomy with a lumbar disc implant was independently associated with improved quality of life among patients with lumbar disc herniation, while age and sex showed no significant association with this outcome. READ ALL READ LESS Keywords Diskectomy, quality of life, Disc Herniation, comorbidity Corresponding Author(s) Martín A. Vilela-Estrada ( [email protected] ) Close Corresponding author: Martín A. Vilela-Estrada Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2026 Nomberto-Orbegoso G et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Nomberto-Orbegoso G, Rodríguez E, Ramírez Espinoza A and Vilela-Estrada MA. Lumbar discectomy with lumbar disc implant and its association with quality of life in patients with lumbar disc herniation at a Peruvian military hospital, 2023–2024 [version 1; peer review: awaiting peer review] . F1000Research 2026, 15 :474 ( https://doi.org/10.12688/f1000research.178759.1 ) First published: 06 Apr 2026, 15 :474 ( https://doi.org/10.12688/f1000research.178759.1 ) Latest published: 06 Apr 2026, 15 :474 ( https://doi.org/10.12688/f1000research.178759.1 ) Introduction Low back pain (LBP) is common and is recognized as a major global health problem. The World Health Organization estimates that musculoskeletal conditions affect approximately 1.71 billion people, and LBP is one of the most frequently reported complaints, with an estimated prevalence of 568 million individuals worldwide. 1 , 2 LBP is also a leading cause of disability across many countries, and despite its high burden, only a minority of patients receive a definitive clinical diagnosis in routine practice. 3 , 4 Lumbar disc herniation (LDH) is one of the most common causes of LBP associated with sciatica and typically occurs at the L4–L5 and L5–S1 levels. 5-7 LDH is often linked to degenerative processes and mechanical–postural factors that contribute to gradual disc wear, including sustained overload, poor posture, excess body weight, and muscular imbalance—particularly weakness of lumbar stabilizing muscles. 4 Disc material displacement through the annulus fibrosus, commonly in the posterolateral region, may irritate or compress lumbar nerve roots and the dural sac, resulting in pain, functional limitation, and reduced quality of life. 8 , 9 Management of LDH includes conservative treatment, interventional procedures, and surgery. Conservative treatment is effective in many patients within four to six weeks and commonly combines medication with supervised rehabilitation strategies; controlled strengthening programs may improve symptoms and function in the short to medium term. 10 , 11 Surgical treatment aims to decompress neural structures and is generally considered in patients with persistent, disabling radicular pain after an adequate trial of conservative management, in the presence of relevant motor deficits, or urgently in severe presentations such as cauda equina syndrome. 7 , 10 In selected refractory cases, therapeutic injections may be used to control radicular and axial pain, including selective foraminal blocks, translaminar epidural injections, and facet blocks; serious complications are reported infrequently. 12 , 13 Because LDH affects pain, daily function, and work capacity, outcomes should be assessed using patient-reported measures in addition to clinical evaluation. Health-related quality of life (HRQoL) reflects physical functioning, pain, emotional well-being, and social participation, and its measurement helps evaluate treatment effectiveness and supports cost–benefit discussions in clinical care. 6 , 14 , 15 Prior studies have described HRQoL changes after different surgical and non-surgical approaches, although results vary depending on technique, rehabilitation, patient characteristics, and follow-up duration. 16 , 17 In Peru, national evidence on HRQoL and disability in LDH remains limited, and available studies have focused mainly on rehabilitation strategies and clinical patterns rather than direct comparisons of HRQoL by surgical approach. 18 , 19 In particular, there is scarce contemporary local evidence assessing HRQoL in patients treated with lumbar discectomy combined with lumbar disc implantation, especially in physically demanding populations such as military personnel. This gap limits local benchmarking and patient counseling and makes it difficult to contextualize outcomes in defense-sector hospitals. Therefore, this study aimed to assess the association between discectomy plus lumbar disc implantation and HRQoL in adults with LDH treated at Hospital Central de la Fuerza Aérea del Perú (Hospital Central FAP), Lima, during 2023–2024, using the SF-36 questionnaire to compare patient-reported outcomes between surgically treated and non-surgically treated patients. 1 , 20 Methods Study design An analytical cross-sectional study was conducted to evaluate the association between discectomy with lumbar disc implant and health-related quality of life in adult patients diagnosed with lumbar disc herniation. The study was carried out at the Hospital Central de la Fuerza Aérea del Perú, Lima, Peru, and included patients evaluated at the outpatient services of Neurosurgery and Physical Medicine and Rehabilitation. The study followed an observational design, as no intervention or modification of clinical management was performed by the investigators. The decision regarding surgical or non-surgical treatment was made exclusively by the treating physicians according to institutional clinical criteria. An analytical approach was adopted to compare quality-of-life outcomes between patients who underwent discectomy with lumbar disc implant and those managed without surgical intervention. Study population and sample The study population consisted of patients aged 18 years or older with a confirmed diagnosis of lumbar disc herniation who were attended at the Hospital Central de la Fuerza Aérea del Perú. According to institutional records, approximately 95 eligible patients were identified during the study period. Given the finite size of the accessible population, a census sampling strategy was applied, and all patients who met the eligibility criteria were included in the analysis. Consequently, the final sample comprised 95 patients. The unit of analysis was the individual patient, assessed through clinical records and standardized questionnaire data. Eligibility criteria Patients were included if they were 18 years of age or older, had a confirmed diagnosis of lumbar disc herniation, had been evaluated or treated within the last two years, and had sufficient reading comprehension to complete the questionnaire. Patients with or without previous surgical intervention, specifically discectomy with lumbar disc implant, were eligible. Patients were excluded if they had undergone lumbar disc surgery at another healthcare institution, if the intervention occurred outside the defined study period, if they were illiterate, under 18 years of age, or if their clinical documentation was incomplete or inconsistent. Data collection procedures Prior to data collection, formal authorization was obtained from the Hospital Central de la Fuerza Aérea del Perú through the Head of the Neurosurgery Service, permitting access to clinical records and outpatient services. Academic authorization was also granted by the Escuela de Medicina Humana of Universidad Privada Antenor Orrego. Data collection was conducted between September and December 2024. All eligible patients received detailed information about the study objectives and procedures, and written informed consent was obtained prior to participation. Health-related quality of life was assessed using the Short Form-36 Health Survey (SF-36), a widely validated instrument with demonstrated reliability in Spanish-speaking populations and in patients with musculoskeletal disorders, showing Cronbach’s alpha coefficients above 0.70 across all domains. The SF-36 evaluates eight dimensions: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. Each domain is scored from 0 to 100, with higher scores indicating better perceived health status. For analytical purposes, overall quality of life was dichotomized into poor quality of life (<50 points) and good quality of life (≥50 points). 20 Data analysis Data were entered into a structured database using Microsoft Excel 2019, and consistency checks were performed prior to analysis. The final dataset was analyzed using STATA V.14. Descriptive statistics were used to summarize sociodemographic and clinical characteristics, with categorical variables presented as frequencies and percentages and continuous variables summarized using appropriate measures of central tendency and dispersion according to their distribution. Normality of continuous variables was assessed using graphical inspection and distributional measures. Associations between categorical variables were evaluated using the Chi-square test or Fisher’s exact test when more than 20% of expected cell counts were below five. Comparisons involving continuous variables were performed using the Student’s t-test when assumptions were met. To estimate the association between discectomy with lumbar disc implant and quality of life, crude prevalence ratios were calculated. Multivariable analysis was conducted using Poisson regression with robust variance to obtain adjusted prevalence ratios, controlling for age and sex. Results were reported with 95% confidence intervals, and statistical significance was set at p < 0.05. 21 Ethical statement This study was conducted in accordance with the principles of the Declaration of Helsinki. 22 Ethical approval was obtained from the Institutional Bioethics Committee of Universidad Privada Antenor Orrego under Resolución Comité de Bioética N°000404–2025-UPAO. Authorization for study implementation and access to clinical data was granted by the Hospital Central de la Fuerza Aérea del Perú through the Head of the Neurosurgery Service. All data were anonymized and coded to ensure confidentiality, and no personal identifiers were recorded. Written informed consent was obtained from all participants prior to data collection. Results A total of 95 patients who underwent lumbar discectomy for lumbar disc herniation at a public hospital in Lima, Peru, between 2023 and 2024 were included in the analysis. Of these, 56 patients received a lumbar disc implant, while 39 underwent discectomy without implant placement. Regarding sex distribution, males predominated in both groups, accounting for 55.4% of patients in the implant group and 53.8% in the non-implant group, while females represented 44.6% and 46.2%, respectively in Table 1 . No statistically significant differences were observed in sex distribution between the two groups (p = 0.879). The mean age of patients with a lumbar disc implant was 45.7 ± 14.1 years, compared to 45.6 ± 14.3 years in those without an implant. Similarly, median age values were comparable between groups, with medians of 46 years (interquartile range [IQR]: 34–56) in the implant group and 44 years (IQR: 33–57) in the non-implant group in Table 1 . No statistically significant differences were identified in age between the groups (p = 0.963), indicating a homogeneous distribution of baseline demographic characteristics in Table 1 . Table 1. Association between sex and age, and patients with lumbar disc herniation with and without discectomy plus lumbar disc implant treated at the central fap hospital during the period 2023–2024. Variable Category With implant (n = 56) Without implant (n = 39) p-value Sex Male 31 (55.4%) 21 (53.8%) 0.879 * Female 25 (44.6%) 18 (46.2%) Age (years) Mean ± SD 45.7 ± 14.1 45.6 ± 14.3 0.963 † Median (IQR) 46 (34–56) 44 (33–57) * Chi-square test. † Student’s t-test. Patients who underwent lumbar discectomy with lumbar disc implant (n = 56) showed consistently higher mean scores across all SF-36 domains compared with those treated without implant (n = 39). In the physical health–related domains, physical function scores were higher in the implant group (33.4 ± 17.1) than in the non-implant group (28.2 ± 16.1), with a mean difference of 5.2 points (95% CI: −1.2 to 11.6), although this difference did not reach statistical significance (p = 0.112). Similarly, role limitations due to physical health were greater among patients with implant (50.2 ± 27.2) compared to those without implant (42.1 ± 25.3), yielding a mean difference of 8.1 points (95% CI: −2.0 to 18.2; p = 0.116). Bodily pain scores were also higher in the implant group (28.8 ± 11.4 vs. 25.7 ± 9.7), with a mean difference of 3.1 points (95% CI: −1.1 to 7.3; p = 0.150). General health perception followed the same trend, with higher mean scores in patients with implant (26.2 ± 7.8) compared to those without implant (23.6 ± 5.8), approaching statistical significance (mean difference: 2.6; 95% CI: −0.1 to 5.3; p = 0.062) in Table 2 . Table 2. Difference IN SF-36 components between patients with and without discectomy plus lumbar disc implant. SF-36 Domain With implant (n = 56) Without implant (n = 39) Mean difference (95% CI) p-value † Physical Function 33.4 ± 17.1 28.2 ± 16.1 5.2 (−1.2 to 11.6) 0.112 Role Physical 50.2 ± 27.2 42.1 ± 25.3 8.1 (−2.0 to 18.2) 0.116 Bodily Pain 28.8 ± 11.4 25.7 ± 9.7 3.1 (−1.1 to 7.3) 0.15 General Health 26.2 ± 7.8 23.6 ± 5.8 2.6 (−0.1 to 5.3) 0.062 Vitality 63.9 ± 18.8 55.0 ± 17.7 8.9 (1.7 to 16.1) 0.016 Social Function 62.6 ± 22.5 54.6 ± 22.6 8.0 (−0.9 to 16.9) 0.079 Role Emotional 88.7 ± 17.3 77.2 ± 21.7 11.5 (3.7 to 19.3) 0.005 Mental Health 78.6 ± 11.5 71.9 ± 12.4 6.7 (1.9 to 11.5) 0.007 † Student’s t-test. In contrast, statistically significant differences were observed in several mental and social health domains. Vitality scores were significantly higher in the implant group (63.9 ± 18.8) than in the non-implant group (55.0 ± 17.7), with a mean difference of 8.9 points (95% CI: 1.7 to 16.1; p = 0.016). Role limitations due to emotional problems were notably greater among patients with implant (88.7 ± 17.3) compared to those without implant (77.2 ± 21.7), demonstrating a significant mean difference of 11.5 points (95% CI: 3.7 to 19.3; p = 0.005) in Table 2 . Likewise, mental health scores were significantly higher in the implant group (78.6 ± 11.5) than in the non-implant group (71.9 ± 12.4), with a mean difference of 6.7 points (95% CI: 1.9 to 11.5; p = 0.007). Although social functioning scores were also higher in patients who received a lumbar disc implant (62.6 ± 22.5) compared to those without implant (54.6 ± 22.6), the observed mean difference of 8.0 points (95% CI: −0.9 to 16.9) did not reach statistical significance (p = 0.079) in Table 2 . Among the patients included in the study, lumbar disc herniation types were similarly distributed between those who underwent lumbar discectomy with disc implant (n = 56) and those treated without implant (n = 39). In the implant group, disc extrusion was the most frequent presentation, observed in 41.1% of cases, followed by sequestered herniation in 21.4%, migrated herniation in 19.6%, and disc protrusion in 17.9% in Table 3 . A comparable pattern was identified in the non-implant group, where extrusion accounted for 43.6% of cases, followed by migrated herniation in 20.5%, protrusion in 20.5%, and sequestered herniation in 15.4%. No statistically significant differences were found in the distribution of herniation types between both groups (p = 0.931), indicating that baseline morphological characteristics of lumbar disc herniation were homogeneous regardless of implant use in Table 3 . Table 3. Association between different types of disc herniation and patients with lumbar disc herniation with and without discectomy plus lumbar disc implant treated at the central fap hospital during the period 2023–2024. Type of herniation With implant (n = 56) Without implant (n = 39) p-value * Protrusion 10 (17.9%) 8 (20.5%) 0.931 Extrusion 23 (41.1%) 17 (43.6%) Migrated 11 (19.6%) 8 (20.5%) Sequestered 12 (21.4%) 6 (15.4%) * Chi-square test. Among patients who underwent lumbar discectomy with lumbar disc implant, the presence of comorbidities was observed in 30 individuals (53.6%), while 26 patients (46.4%) reported no associated comorbid conditions. The overall quality of life, assessed using the SF-36 total score, was slightly lower in patients with comorbidities compared to those without comorbidities (52.7 ± 12.9 vs. 56.4 ± 13.6, respectively) in Table 4 . However, this difference did not reach statistical significance (p = 0.323), indicating that the presence of comorbidities was not significantly associated with variations in overall quality of life among patients treated with lumbar disc implantation during the study period in Table 4 . Table 4. Relationship between the presence of comorbidities and postoperative quality of life in patients with lumbar disc herniation undergoing discectomy plus lumbar disc implant at fap lima hospital 2023–2024. Comorbidity With implant (n = 56) SF-36 total (Mean ± SD) p-value † Present 30 (53.6%) 52.7 ± 12.9 0.323 Absent 26 (46.4%) 56.4 ± 13.6 † Student’s t-test. In the multivariable analysis assessing factors associated with quality of life among patients with lumbar disc herniation treated at a public hospital in Lima, Peru, during 2023–2024, lumbar discectomy with lumbar disc implant was significantly associated with better quality-of-life outcomes. Patients who underwent discectomy with implant showed a higher prevalence of improved quality of life compared with those without implant placement, both in the crude analysis (PR: 1.66; 95% CI: 1.00–2.76; p = 0.05) and after adjustment for potential confounders (adjusted PR: 1.68; 95% CI: 1.02–2.79; p = 0.043) in Table 5 . In contrast, age was not significantly associated with quality of life, either in the crude model (PR per year: 1.01; 95% CI: 0.99–1.03; p = 0.408) or in the adjusted analysis (adjusted PR: 1.01; 95% CI: 0.99–1.03; p = 0.373), indicating no meaningful effect of increasing age on the outcome. Similarly, sex did not show a significant association with quality of life, as female patients had a prevalence ratio comparable to male patients in both the crude (PR: 0.92; 95% CI: 0.61–1.39; p = 0.684) and adjusted models (adjusted PR: 0.91; 95% CI: 0.61–1.37; p = 0.651) in Table 5 . Table 5. Multivariate analysis of the association between quality of life in patients with lumbar disc herniation and whether or not they underwent discectomy with lumbar disc implant as treatment at the central fap-lima hospital during the period 2023–2024. Variable Crude PR (95% CI) p-value Adjusted PR* (95% CI) p-value With Implant 1.66 (1.00–2.76) 0.05 1.68 (1.02–2.79) 0.043 Age (per year) 1.01 (0.99–1.03) 0.408 1.01 (0.99–1.03) 0.373 Sex (F vs M) 0.92 (0.61–1.39) 0.684 0.91 (0.61–1.37) 0.651 Discussion Our findings suggest that lumbar discectomy combined with disc implantation is associated with better health-related quality of life compared with discectomy alone in Peruvian adults with lumbar disc herniation. Patients who received an implant showed a 68% higher prevalence of improved quality of life after adjustment for age and sex (adjusted PR: 1.68; 95% CI: 1.02–2.79; p = 0.043). The largest differences were observed in vitality, emotional role, and mental health domains, whereas physical domains showed modest and non-significant improvements. This pattern is consistent with the findings of Häkkinen et al., 23 who reported that quality-of-life improvements after lumbar disc surgery extend beyond physical recovery to include emotional and social dimensions. Similarly, the systematic review by Ostelo et al. 24 emphasized the multidimensional nature of postoperative recovery and the importance of rehabilitation in functional outcomes. A plausible explanation is that effective neural decompression rapidly relieves radicular pain, restoring patients’ confidence in movement and daily activities. In the longitudinal study by Atlas et al., 25 symptomatic relief after surgery was associated with sustained improvements in perceived well-being. Likewise, the randomized trial by Peul et al. 26 demonstrated that surgery provides faster pain relief compared with prolonged conservative treatment, which may explain why vitality and emotional role scores were significantly higher in the implant group in our cohort, despite non-significant differences in physical domains. Our results are also consistent with the long-term follow-up of the Maine Lumbar Spine Study led by Atlas et al., 27 which demonstrated substantial quality-of-life improvements after discectomy, particularly among working-age adults. Additionally, the SPORT trial conducted by Weinstein et al. 28 showed that surgical benefits in lumbar disc herniation are primarily driven by symptom relief and functional improvement rather than demographic factors such as age. In our study, age was not significantly associated with quality of life, aligning with these findings. 28 Regarding disc implantation, evidence remains more heterogeneous. Zigler and Delamarter 29 have suggested that lumbar disc arthroplasty may preserve segmental motion and improve patient satisfaction. Furthermore, the meta-analysis by Park et al. 30 reported favorable clinical and radiological outcomes following lumbar total disc replacement. Although bodily pain did not differ significantly between groups in our study, the higher psychosocial domain scores may reflect perceived biomechanical stability and functional confidence as described by these authors. 29 , 30 Strengths of this study include the use of the validated SF-36 questionnaire developed by Ware and Sherbourne, 31 which provides comprehensive assessment of health-related quality of life. Baseline homogeneity between groups and the use of prevalence ratios with robust variance strengthen internal validity. However, the cross-sectional design limits causal inference. The absence of randomization may introduce confounding by indication, as also discussed in the comparative studies by Peul et al. 26 and Weinstein et al. 28 Future prospective studies are needed to determine whether these differences persist over time and represent clinically meaningful long-term benefits. 27 , 29 Conclusion Lumbar discectomy with disc implantation was associated with a higher prevalence of improved health-related quality of life, particularly in vitality, emotional role, and mental health domains. However, due to the cross-sectional design, non-random treatment allocation, and potential residual confounding, these findings should be interpreted cautiously and do not establish causality. Data availability The data underlying this study are openly available in Figshare at: https://doi.org/10.6084/m9.figshare.31359904 . 32 The repository contains the complete raw dataset supporting all analyses reported in this article, including data used to generate descriptive statistics (means, standard deviations, and related measures), as well as the datasets used to construct all tables and figures. A detailed data dictionary describing each study variable (e.g., age, sex, occupation, and other relevant clinical and demographic variables) is also provided. All datasets have been fully anonymized prior to public release to ensure participant confidentiality and compliance with ethical standards. Extended data Extended materials related to this study are also available in the Figshare repository at: https://doi.org/10.6084/m9.figshare.31359904 . 32 These materials include the full questionnaire instrument used in this study, supplementary tables, and additional methodological documentation supporting the analyses. All extended data and associated materials are distributed under the Creative Commons Attribution 4.0 International (CC BY 4.0) license . This license permits unrestricted use, distribution, and reproduction in any medium, provided appropriate credit is given to the original authors and source. References 1. World Health Organization: Musculoskeletal conditions. Geneva: WHO; 2021 [cited 2025 Nov]. Reference Source 2. Hartvigsen J, Hancock MJ, Kongsted A, et al. : What low back pain is and why we need to pay attention. Lancet. 2018; 391 (10137): 2356–2367. Publisher Full Text 3. 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Lima: CID – Center for Research and Development; 2024. 978-99989-67-36-6. Publisher Full Text Reference Source 22. World Medical Association: WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Participants. Ferney-Voltaire, France: World Medical Association; 1964–2024. Adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964; latest revision October 19, 2024 [cited 2025 Feb 1]. Reference Source 23. Häkkinen A, Kautiainen H, Hannonen P, et al. : Health-related quality of life after lumbar disc surgery. Spine (Phila Pa 1976). 2007; 32 (4): 423–429. 24. Ostelo RWJG, Costa LOP, Maher CG, et al. : Rehabilitation after lumbar disc surgery. Spine. 2009; 34 (17): 1839–1848. 25. Atlas SJ, Keller RB, Wu YA, et al. : Long-term outcomes of surgical and nonsurgical management of sciatica secondary to lumbar disc herniation. Spine. 2005; 30 (8): 927–935. 26. 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Nomberto Orbegoso EG: Lumbar discectomy with lumbar disc implant and its association with quality of life in patients with lumbar disc herniation at a Peruvian military hospital, 2023–2024. Dataset. figshare. 2026. Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 06 Apr 2026 ADD YOUR COMMENT Comment Author details Author details 1 La Libertad, Universidad Privada Antenor Orrego, Trujillo, Trujillo, 13001, Peru 2 Lima, Instituto Nacional de Salud del Niño San Borja, Lima, Perú, 15037, Peru Gianfranco Nomberto-Orbegoso Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Ernesto Rodríguez Roles: Data Curation, Investigation, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Alberto Ramírez Espinoza Roles: Formal Analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Martín A. Vilela-Estrada Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 06 Apr 2026, 15:474 https://doi.org/10.12688/f1000research.178759.1 Copyright © 2026 Nomberto-Orbegoso G et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. 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