Surgical Results of Herniated Lumbar Disc

ABSTRACT

The surgical outcome for lumbar discectomy has improved with development of surgical techniques and strict selection of patients. The authors could follow up and analyse 818 cases who underwent surgery due to herniated lumbar disc from Jan. 1980 to Dec. 1991 at Chonbuk National University Hospital. The early operative complications were delayed wound healing(36 cases), extradural hermatoma(2 cases), discitis(2 cases), but there was no injury to nerve root and abdominal vessels. The specially designed paravertebral muscle retractor and nerve root retractor were useful in reducing the operative complications. Sixteen patients were reoperated due to acute recurrent symptoms(within one month). More than one-third of these(7/16) were due to missed disc material, and all of them had good results after reoperation. Twenty five patients were reoperated due to late recurrent symptoms(more than 6 months later). In almost two-third of them(14/25), rerupture of remained disc material was found. Reoperation of these cases had a good result as well. Epidural fibrosis and severe adhesion of nerve root were showed for reoperation in 9 of the 25 cases. These complications had a poor result except 1 case even after reoperation. The surgical outcome of 818 cases were classified ; Excellent 618 cases(82%), Good 110 cases(13.5%), Fair 29 cases(3.5%) and Poor 8 cases(1%). Surgical technique and proper selection of patients were considered as important facter obtaining the better result.