Contemporary studies of lumbar disc surgery document postoperative success rates between 49% and 97%7,8. Predictors of outcome include epidemiological, clinical, radiographic and psychosocial aspects7,9,10. Also the type of lumbar disc herniation (prolapse or protrusion vs. extrusion or sequestration) appears to be relevant for prediction of outcome, but not the anatomical position (paramedian, postero-lateral, intraforaminal and extraforaminal) of the lumbar disc herniation with the exception of central lumbar disc herniation11,12,13.
Postoperative outcome of lumber disc herniation was considered successful in our study in 68% of patients. This number appears to be much lower as compared with the outcome after operation for the more common paramedian or postero-lateral disc herniations. In a recent follow-up study at our institution of 103 selected patients with lumbar microdiscectomy other than central lumbar disc herniations the long-term …show more content…
Knop-Jergas and colleagues16 believe that the reason for the worse outcome may rather by an unstable segment with a central herniation in the first place than the surgical approach itself. Probably a nucleus pulposus protruding through the central portion of the annulus fibrosus weakens the architecture of the disc more than any other type of protrusion or herniation.
Recovery from sciatica makes early surgery likely to be more cost effective than prolong conservative care19. A Cochraine review20 summarized some trials evaluating surgery and chemonucleolysis for prolapsed disc, showing better results with surgery than chemonucleolysis. The standard treatment of prolapsed lumber disc has been surgical excision of the disc, though the methods of discectomy vary. The traditional view has been that wide laminectomy produces increased morbidity compared to less extensive procedures like inter-laminar fenestration
Postoperative outcome of lumber disc herniation was considered successful in our study in 68% of patients. This number appears to be much lower as compared with the outcome after operation for the more common paramedian or postero-lateral disc herniations. In a recent follow-up study at our institution of 103 selected patients with lumbar microdiscectomy other than central lumbar disc herniations the long-term …show more content…
Knop-Jergas and colleagues16 believe that the reason for the worse outcome may rather by an unstable segment with a central herniation in the first place than the surgical approach itself. Probably a nucleus pulposus protruding through the central portion of the annulus fibrosus weakens the architecture of the disc more than any other type of protrusion or herniation.
Recovery from sciatica makes early surgery likely to be more cost effective than prolong conservative care19. A Cochraine review20 summarized some trials evaluating surgery and chemonucleolysis for prolapsed disc, showing better results with surgery than chemonucleolysis. The standard treatment of prolapsed lumber disc has been surgical excision of the disc, though the methods of discectomy vary. The traditional view has been that wide laminectomy produces increased morbidity compared to less extensive procedures like inter-laminar fenestration