Summary
The indications for operative treatment of lumbar disc herniations are outlined and the advantages, short-comings and temptations of discolysis, microoperation and large approach discussed.
The following indication scheme is proposed:
Discolysis: Non-displaced disc herniation without other major causative pathology
Micro-operation: Displaced disc herniation; nondisplaced disc herniation with monosegmental additional causative factors
Large approach: Multiple disc herniations with suspected displacement and multisegmental additional pathologies.
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References
For literature see the following review article and monograph
Loew, F., W. Caspar: Surgical approach to lumbar disc herniation. In: Krayenbühl, H., et al. “Advances and Technical Standards in Neurosurgery”, Vol. 5, pp. 153–174. Springer, Wien—New York 1978
McCulloch, J. A., I. McNab: Sciatica and Chymopapain. Williams and Wilkins, Baltimore—London 1983
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Loew, F. Different operative possibilities for treatment of lumbar disc herniations — how to choose the best method for the individual patient. Neurosurg. Rev. 9, 109–111 (1986). https://doi.org/10.1007/BF01743060
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DOI: https://doi.org/10.1007/BF01743060