Clinical Orthopaedics and Related Research®

, Volume 473, Issue 6, pp 1885–1895 | Cite as

A History of Lumbar Disc Herniation From Hippocrates to the 1990s

  • Eeric TruumeesEmail author
Symposium: Current Approaches to the Management of Lumbar Disc Herniation


In ancient times, a supernatural understanding of the syndrome of lumbar radiculopathy often involved demonic forces vexing the individual with often crippling pain. The ancient Greeks and Egyptians began to take a more naturalistic view and, critically, suspected a relationship between lumbar spinal pathology and leg symptoms. Relatively little then changed for those with sciatica until the classic works by Cotugno and Kocher arrived in the late 18th century. Early lumbar canal explorations were performed in the late 1800s and early 1900s by MacEwen, Horsley, Krause, Taylor, Dandy, and Cushing, among others. In these cases, when compressive pathologies were found and removed, the lesions typically were (mis-)identified as enchondromas or osteochondritis dissecans. To better understand the history, learn more about the first treatments of lumbar disc herniation, and evaluate the impact of the early influences on modern spine practice, searches of PubMed and Embase were performed using the search terms discectomy, medical history, lumbar spine surgery, herniated disc, herniated nucleus pulposus, sciatica, and lumbar radiculopathy. Additional sources were identified from the reference lists of the reviewed papers. Many older and ancient sources including De Ischiade Nervosa are available in English translations and were used. When full texts were not available, English abstracts were used. The first true, intentional discectomy surgery was performed by Mixter and Barr in 1932. Early on, a transdural approach was favored. In 1938, Love described the intralaminar, extradural approach. His technique, although modified with improved lighting, magnification, and retractors, remains a staple approach to disc herniations today. Other modalities such as chymopapain have been investigated. Some remain a part of the therapeutic armamentarium, whereas others have disappeared. By the 1970s, CT scanning after myelography markedly improved the clinical evaluation of patients with lumbar disc herniation. In this era, use of discectomy surgery increased rapidly. Even patients with very early symptoms were offered surgery. Later work, especially by Weber and Hakelius, showed that many patients with lumbar disc herniation would improve without surgical intervention. In the ensuing decades, the debate over operative indications and timing continued, reaching another pivotal moment with the 2006 publication of the initial results of Spine Patient Outcomes Research Trial.


Nucleus Pulposus Disc Herniation Lumbar Disc Herniation Osteochondritis Dissecans Cauda Equina Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Abdel-Salam A, Eyres KS, Cleary J. Management of the herniated lumbar disc: the outcome after chemonucleolysis, surgical disc excision and conservative treatments. Eur Spine J. 1992;1:89–95.CrossRefPubMedGoogle Scholar
  2. 2.
    Alajouanine T, Petit-Dutaillis D. Fibrocartilage nodules from the posterior aspect of the intervertebral disc. Presse Méd. 1930;98:1657.Google Scholar
  3. 3.
    Alemo S, Sayadipour A. Sources and patterns of pain in lumbar disc disease: revisiting Francis Murphey’s theory. Acta Neurochir (Wien). 2010;152:1555–1558.CrossRefPubMedGoogle Scholar
  4. 4.
    Alexander E Jr. Lumbar disk lesions in retrospect and prospect. Surg Neurol. 1992;38:315–317.CrossRefPubMedGoogle Scholar
  5. 5.
    Alexandre A, Coro L, Azuelos A, Buric J, Salgado H, Murga M, Marin F, Giocoli H. Intradiscal injection of oxygen-ozone gas mixture for the treatment of cervical disc herniations. Acta Neurochir Suppl. 2005;92:79–82.CrossRefPubMedGoogle Scholar
  6. 6.
    An HS, Simpson JM, Stein R. Outpatient laminotomy and discectomy. J Spinal Disord. 1999;12:192–196.CrossRefPubMedGoogle Scholar
  7. 7.
    Anderson MW. Lumbar discography: an update. Semin Roentgenol. 2004;39:52–67.CrossRefPubMedGoogle Scholar
  8. 8.
    Atlas SJ, Deyo RA, Keller RB, Chapin AM, Patrick DL, Long JM, Singer DE. The Maine Lumbar Spine Study, Part II. 1-year outcomes of surgical and nonsurgical management of sciatica. Spine (Phila Pa 1976). 1996;21:1777–1786.Google Scholar
  9. 9.
    Auralianus C. Acute Diseases and Chronic Diseases. Chicago, IL, USA: University of Chicago Press; 1950.Google Scholar
  10. 10.
    Ballantine HT Jr. ‘Sciatica’ and the neurosurgeon: historical perspectives and personal reminiscences. Clin Neurosurg. 1980;27:541–552.PubMedGoogle Scholar
  11. 11.
    Barr JS. Ruptured intervertebral disc and sciatic pain. J Bone Joint Surg Am. 1947;29:429–437.PubMedGoogle Scholar
  12. 12.
    Barr JS, Kubik CS, Molloy MK. Evaluation of end results in treatment of ruptured lumbar intervertebral disc with protrusion of nucleus pulposis. Surg Gynecol Obstet. 1967;125:250–256.Google Scholar
  13. 13.
    Barrios C, Ahmed M, Arrotegui J, Bjornsson A, Gillstrom P. Microsurgery versus standard removal of the herniated lumbar disc. A 3-year comparison in 150 cases. Acta Orthop Scand. 1990;61:399–403.CrossRefPubMedGoogle Scholar
  14. 14.
    Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72:403–408.PubMedGoogle Scholar
  15. 15.
    Brock M, Patt S, Mayer HM. The form and structure of the extruded disc. Spine (Phila Pa 1976). 1992;17:1457–1461.Google Scholar
  16. 16.
    Cares HL, Steinberg RS, Robertson ET, Caldini P. Ambulatory microsurgery for ruptured lumbar discs: report of ten cases. Neurosurgery. 1988;22:523–526.CrossRefPubMedGoogle Scholar
  17. 17.
    Carragee EJ, Han MY, Suen PW, Kim D. Clinical outcomes after lumbar discectomy for sciatica: the effects of fragment type and anular competence. J Bone Joint Surg Am. 2003;85:102–108.PubMedGoogle Scholar
  18. 18.
    Carragee EJ, Han MY, Yang B, Kim DH, Kraemer H, Billys J. Activity restrictions after posterior lumbar discectomy. A prospective study of outcomes in 152 cases with no postoperative restrictions. Spine (Phila Pa 1976). 1999;24:2346–2351.Google Scholar
  19. 19.
    Carragee EJ, Helms E, O’Sullivan GS. Are postoperative activity restrictions necessary after posterior lumbar discectomy? A prospective study of outcomes in 50 consecutive cases. Spine (Phila Pa 1976). 1996;21:1893–1897.Google Scholar
  20. 20.
    Caspar W. A new surgical procedure for lumbar disc herniation causing less tissue damage through a microsurgical approach. Adv Neurosurg. 1977;4:74–80.Google Scholar
  21. 21.
    Caspar W, Campbell B, Barbier DD, Kretschmmer R, Gotfried Y. The Caspar microsurgical discectomy and comparison with a conventional standard lumbar disc procedure. Neurosurgery. 1991;28:78–86; discussion 86–87.Google Scholar
  22. 22.
    Castro I, Santos DP, Christoph Dde H, Landeiro JA. The history of spinal surgery for disc disease: an illustrated timeline. Arq Neuropsiquiatr. 2005;63:701–706.CrossRefPubMedGoogle Scholar
  23. 23.
    Cauchoix J, Ficat C, Girard B. Repeat surgery after disc excision. Spine (Phila Pa 1976). 1978;3:256–259.Google Scholar
  24. 24.
    Chedid KJ, Chedid MK. The ‘tract’ of history in the treatment of lumbar degenerative disc disease. Neurosurg Focus. 2004;16:E7.PubMedGoogle Scholar
  25. 25.
    Chiu JC. Evolving transforaminal endoscopic microdecompression for herniated lumbar discs and spinal stenosis. Surg Technol Int. 2004;13:276–286.PubMedGoogle Scholar
  26. 26.
    Choy DS, Ascher PW, Ranu HS, Saddekni S, Alkaitis D, Liebler W, Hughes J, Diwan S, Altman P. Percutaneous laser disc decompression. A new therapeutic modality. Spine (Phila Pa 1976). 1992;17:949–956.Google Scholar
  27. 27.
    Colak A, Bavbek M, Aydin NE, Renda N, Acikgoz B. Effect of CO2 laser on spinal epidural fibrosis. Acta Neurochir (Wien). 1996;138:162–166.CrossRefPubMedGoogle Scholar
  28. 28.
    Cotugno D. The Ischial Nerve. Naples, Italy: Fratres Simonios; 1764.Google Scholar
  29. 29.
    Dandy W. Loose cartilage from intervertebral disk simulating tumor of the spinal cord. Arch Surg. 1929;19:660–672.CrossRefGoogle Scholar
  30. 30.
    Dandy WE. Loose cartilage from intervertebral disk simulating tumor of the spinal cord. By Walter E. Dandy, 1929. Clin Orthop Relat Res. 1989;238:4–8.PubMedGoogle Scholar
  31. 31.
    Darden BV 2nd, Wade JF, Alexander R, Wood KE, Rhyne AL 3rd, Hicks JR. Far lateral disc herniations treated by microscopic fragment excision. Techniques and results. Spine (Phila Pa 1976). 1995;20:1500–1505.Google Scholar
  32. 32.
    Davis H. Increasing rates of cervical and lumbar spine surgery in the United States, 1979–1990. Spine (Phila Pa 1976). 1994;19:1117–1123; discussion 1123–1124.Google Scholar
  33. 33.
    De Sèze S. ‘Banal” sciatica and lumbosacral discs. Presse Méd. 1940;48:570–577.Google Scholar
  34. 34.
    Deburge A, Benoist M, Boyer D. The diagnosis of disc sequestration. Spine (Phila Pa 1976). 1984;9:496–499.Google Scholar
  35. 35.
    Deyo RA. Results of discectomy compared with discectomy and fusion. Acta Orthop Scand Suppl. 1993;251:45–46.CrossRefPubMedGoogle Scholar
  36. 36.
    Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine (Phila Pa 1976). 1987;12:264–268.Google Scholar
  37. 37.
    Ditzler JW, Dumke PR, Harrington JJ, Fox JD. Should spinal anesthesia be used in surgery for herniated intervertebral disk. Anesth Analg. 1959;38:118–124.CrossRefPubMedGoogle Scholar
  38. 38.
    Epstein NE. Laser-assisted diskectomy performed by an internist resulting in cauda equina syndrome. J Spinal Disord. 1999;12:77–79.PubMedGoogle Scholar
  39. 39.
    Espersen JO, Kosteljanetz M, Halaburt H, Miletic T. Predictive value of radiculography in patients with lumbago-sciatica. A prospective study (Part II). Acta Neurochir (Wien). 1984;73:213–221.Google Scholar
  40. 40.
    Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze G. Lumbar disc nomenclature: version 2.0. Spine (Phila Pa 1976). 2013 Aug 21 [Epub ahead of print].Google Scholar
  41. 41.
    Fernstrom U. Lumbar intervertebral disc degeneration with abdominal pain. Acta Chir Scand. 1957;113:436–437.PubMedGoogle Scholar
  42. 42.
    Fritsch EW, Heisel J, Rupp S. The failed back surgery syndrome: reasons, intraoperative findings, and long-term results: a report of 182 operative treatments. Spine (Phila Pa 1976). 1996;21:626–633.Google Scholar
  43. 43.
    Goldthwait J, Osgood R. A consideration of the pelvic articulations from an anatomical, pathological and clinical standpoint. Boston Med Surg J. 1905;152:365–372.CrossRefGoogle Scholar
  44. 44.
    Hakelius A. Prognosis in sciatica. A clinical follow-up of surgical and non-surgical treatment. Acta Orthop Scand Suppl. 1970;129:1–76.CrossRefPubMedGoogle Scholar
  45. 45.
    Herron L. Recurrent lumbar disc herniation: results of repeat laminectomy and discectomy. J Spinal Disord. 1994;7:161–166.CrossRefPubMedGoogle Scholar
  46. 46.
    Herron LD, Turner JA, Novell LA, Kreif SL. Patient selection for lumbar discectomy with a revised objective rating system. Clin Orthop Relat Res. 1996;325:148–155.CrossRefPubMedGoogle Scholar
  47. 47.
    Hijikata S, Yamagishi M. Percutaneous discectomy. A new treatment method for lumbar disc herniation. J Toden Hosp. 1975;5:5–13.Google Scholar
  48. 48.
    Hippocrates. The Genuine Works of Hippocrates (translated by Adams F). New York, NY, USA: W. Wood; 1929.Google Scholar
  49. 49.
    Hirabayashi S, Kumano K, Ogawa Y, Aota Y, Maehiro S. Microdiscectomy and second operation for lumbar disc herniation. Spine (Phila Pa 1976). 1993;18:2206–2211.Google Scholar
  50. 50.
    Inman VT, Saunders JB. Anatomicophysiological aspects of injuries to the intervertebral disc. J Bone Joint Surg Am. 1947;29:461–475.PubMedGoogle Scholar
  51. 51.
    Jellish WS, Thalji Z, Stevenson K, Shea J. A prospective randomized study comparing short- and intermediate-term perioperative outcome variables after spinal or general anesthesia for lumbar disk and laminectomy surgery. Anesth Analg. 1996;83:559–564.PubMedGoogle Scholar
  52. 52.
    Jonsson B, Stromqvist B. Repeat decompression of lumbar nerve roots. A prospective two-year evaluation. J Bone Joint Surg Br. 1993;75:894–897.PubMedGoogle Scholar
  53. 53.
    Junge A, Dvorak J, Ahrens S. Predictors of bad and good outcomes of lumbar disc surgery. A prospective clinical study with recommendations for screening to avoid bad outcomes. Spine (Phila Pa 1976). 1995;20:460–468.Google Scholar
  54. 54.
    Kahanovitz N, Viola K, Muculloch J. Limited surgical discectomy and microdiscectomy. A clinical comparison. Spine (Phila Pa 1976). 1989;14:79–81.Google Scholar
  55. 55.
    Karampelas I, Boev AN 3rd, Fountas KN, Robinson JS Jr. Sciatica: a historical perspective on early views of a distinct medical syndrome. Neurosurg Focus. 2004;16:E6.PubMedGoogle Scholar
  56. 56.
    Kawaguchi Y, Kanamori M, Ishihara H, Ohmori K, Matsui H, Kimura T. The association of lumbar disc disease with vitamin-D receptor gene polymorphism. J Bone Joint Surg Am. 2002;84:2022–2028.PubMedGoogle Scholar
  57. 57.
    Kerr RS, Cadoux-Hudson TA, Adams CB. The value of accurate clinical assessment in the surgical management of the lumbar disc protrusion. J Neurol Neurosurg Psychiatry. 1988;51:169–173.CrossRefPubMedCentralPubMedGoogle Scholar
  58. 58.
    Kim YS, Chin DK, Yoon DH, Jin BH, Cho YE. Predictors of successful outcome for lumbar chemonucleolysis: analysis of 3000 cases during the past 14 years. Neurosurgery. 2002;51(Suppl):S123–128.PubMedGoogle Scholar
  59. 59.
    Knoeller SM, Seifried C. Historical perspective: history of spinal surgery. Spine (Phila Pa 1976). 2000;25:2838–2843.Google Scholar
  60. 60.
    Kocher T. Spinal injuries described relative to the physiology of the human spinal cord. Mitt Grenzgeb Med Chir. 1896:415–480.Google Scholar
  61. 61.
    Konttinen YT, Gronblad M, Antti-Poika I, Seitsalo S, Santavirta S, Hukkanen M, Polak JM.. Neuroimmunohistochemical analysis of peridiscal nociceptive neural elements. Spine (Phila Pa 1976). 1990;15:383–386.Google Scholar
  62. 62.
    Kosteljanetz M, Espersen JO, Halaburt H, Miletic T. Predictive value of clinical and surgical findings in patients with lumbago-sciatica. A prospective study (Part I). Acta Neurochir (Wien). 1984;73:67–76.Google Scholar
  63. 63.
    Kotilainen E, Valtonen S. Clinical instability of the lumbar spine after microdiscectomy. Acta Neurochir (Wien). 1993;125:120–126.CrossRefPubMedGoogle Scholar
  64. 64.
    Kutumbiah P. Ancient Indian Medicine. Calcutta: Orient Longmans; 1962.Google Scholar
  65. 65.
    Love J. Removal of protruded intervertebral disc without laminectomy. Proc Staff Meet Mayo Clin. 1939;14:800–805.Google Scholar
  66. 66.
    Love J, Walsh M. Protruded intervertebral disks. Report of one hundred cases in which operation was performed. JAMA. 1938;111:396–400.CrossRefGoogle Scholar
  67. 67.
    Luschka H, ed. The Half Joints of the Human Body. Berlin, Germany: Deutche Ned Wochenschrift; 1858.Google Scholar
  68. 68.
    Malter AD, Larson EB, Urban N, Deyo RA. Cost-effectiveness of lumbar discectomy for the treatment of herniated intervertebral disc. Spine (Phila Pa 1976). 1996;21:1048–1054; discussion 1055.Google Scholar
  69. 69.
    Marketos SG, Skiadas P. Hippocrates. The father of spine surgery. Spine (Phila Pa 1976). 1999;24:1381–1387.Google Scholar
  70. 70.
    Marketos SG, Skiadas PK. Galen: a pioneer of spine research. Spine (Phila Pa 1976). 1999;24:2358–2362.Google Scholar
  71. 71.
    Matsui H, Kanamori M, Ishihara H, Yudoh K, Naruse Y, Tsuji H. Familial predisposition for lumbar degenerative disc disease. A case-control study. Spine (Phila Pa 1976). 1998;23:1029–1034.Google Scholar
  72. 72.
    McCulloch JA. Focus issue on lumbar disc herniation: macro- and microdiscectomy. Spine (Phila Pa 1976). 1996;21(Suppl):45S–56S.Google Scholar
  73. 73.
    Menchetti PP, Canero G, Bini W. Percutaneous laser discectomy: experience and long term follow-up. Acta Neurochir Suppl. 2011;108:117–121.CrossRefPubMedGoogle Scholar
  74. 74.
    Mettler C, Mettler F. History of Medicine: A Correlative Text. Philadelphia, PA, USA: Blakiston; 1947.Google Scholar
  75. 75.
    Mixter W, Barr J. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med. 1934;211:210–215.CrossRefGoogle Scholar
  76. 76.
    Murphey F. Sources and patterns of pain in disc disease. Clin Neurosurg. 1968;15:343–351.PubMedGoogle Scholar
  77. 77.
    Newman MH. Outpatient conventional laminotomy and disc excision. Spine (Phila Pa 1976). 1995;20:353–355.Google Scholar
  78. 78.
    Olmarker K, Rydevik B. Pathophysiology of sciatica. Orthop Clin North Am. 1991;22:223–234.PubMedGoogle Scholar
  79. 79.
    Onik G, Helmes C. Percutaneous lumbar discectomy using a new aspiration probe. AJR Am J Roentgenol. 1985;144:1137–1140.CrossRefPubMedGoogle Scholar
  80. 80.
    Oppenheim H, Krause F. About the entrapment or strangulation of the cauda equina. Dtsch Med Wochenschr. 1909;35:697–700.CrossRefGoogle Scholar
  81. 81.
    Ozgen S, Naderi S, Ozek MM, Pamir MN. Findings and outcome of revision lumbar disc surgery. J Spinal Disord. 1999;12:287–292.CrossRefPubMedGoogle Scholar
  82. 82.
    Padua R. The history of the diagnosis and treatment of lumbar sciatic disc herniation. Chir Organi Mov. 1999;84:367–373.PubMedGoogle Scholar
  83. 83.
    Patwardhan AG, Carandang G, Ghanayem AJ, Havey RM, Cunningham B, Voronov LI, Phillips FM.. Compressive preload improves the stability of anterior lumbar interbody fusion cage constructs. J Bone Joint Surg Am. 2003;85:1749–1756.PubMedGoogle Scholar
  84. 84.
    Patwardhan RV, Hadley MN. History of surgery for ruptured disk. Neurosurg Clin N Am. 2001;12:173–179, x.Google Scholar
  85. 85.
    Paulus A. The Seven Books of Paulus. London, UK: Syndenham Society Publications; 1844.Google Scholar
  86. 86.
    Pearce J, Moll JMH. Conservative treatment and natural history of acute lumbar disc lesions. J Neurol Neurosurg Psychiatry. 1967;30:13–17.CrossRefPubMedCentralGoogle Scholar
  87. 87.
    Postacchini F, Cinotti G, Gumina S. Microsurgical excision of lateral lumbar disc herniation through an interlaminar approach. J Bone Joint Surg Br. 1998;80:201–207.86.Google Scholar
  88. 88.
    Postacchini F, Postacchini R. Operative management of lumbar disc herniation: the evolution of knowledge and surgical techniques in the last century. Acta Neurochir Suppl. 2011;108:17–21.CrossRefPubMedGoogle Scholar
  89. 89.
    Preuss J. Biblical and Talmudic Medicine. New York, NY, USA: Sanhedrin Press; 1978.Google Scholar
  90. 90.
    Ramos G, Martin W. Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg. 1994;81:350–353.CrossRefPubMedGoogle Scholar
  91. 91.
    Robinson JS. Sciatica and the lumbar disk syndrome: a historic perspective. South Med J. 1983;76:232–238.CrossRefPubMedGoogle Scholar
  92. 92.
    Rogers LA. Experience with limited versus extensive disc removal in patients undergoing microsurgical operations for ruptured lumbar discs. Neurosurgery. 1988;22:82–85.CrossRefPubMedGoogle Scholar
  93. 93.
    Saal JA, Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. Spine (Phila Pa 1976). 1989;14:431–437.Google Scholar
  94. 94.
    Salenius P, Laurent LE. Results of operative treatment of lumbar disc herniation. A survey of 886 patients. Acta Orthop Scand. 1977;48:630–634.CrossRefPubMedGoogle Scholar
  95. 95.
    Schmorl G, Junghanns H. The Human Spine in Health and Disease: Anatomicopathologic Studies. 1st American ed. New York, NY, USA: Grune & Stratton; 1959.Google Scholar
  96. 96.
    Schoenfeld AJ. Historical contributions from the Harvard system to adult spine surgery. Spine (Phila Pa 1976). 2011;36:E1477–1484.Google Scholar
  97. 97.
    Shterenshis MV. The history of modern spinal traction with particular reference to neural disorders. Spinal Cord. 1997;35:139.CrossRefPubMedGoogle Scholar
  98. 98.
    Sicard J, Forestier J. Diagnostic and Therapeutic Uses of Lipidiol. Paris, France: Masson; 1928.Google Scholar
  99. 99.
    Sigerist H. A History of Medicine. London, UK: Luzac; 1934.Google Scholar
  100. 100.
    Silvers HR. Microsurgical versus standard lumbar discectomy. Neurosurgery. 1988;22:837–841.CrossRefPubMedGoogle Scholar
  101. 101.
    Smith L. Enzyme dissolution of nucleus pulposus in humans. JAMA. 1964;187:137–140.CrossRefPubMedGoogle Scholar
  102. 102.
    Sonntag V. History of degenerative and traumatic disease of the spine. In: Samuel H, Greenblatt T, Forcht D, Epstein M, eds. A History of Neurosurgery: In Its Scientific and Professional Contexts. Park Ridge, IL, USA: American Association of Neurological Surgeons; 1997.Google Scholar
  103. 103.
    Spengler DM. Lumbar discectomy. Results with limited disc excision and selective foraminotomy. Spine (Phila Pa 1976). 1982;7:604–607.Google Scholar
  104. 104.
    Spengler DM, Ouellette EA, Battie M, Zeh J. Elective discectomy for herniation of a lumbar disc. Additional experience with an objective method. J Bone Joint Surg Am. 1990;72:230–237.PubMedGoogle Scholar
  105. 105.
    Tan WS, Spigos DG, Khine N, Capek V. Computed air myelography of the lumbosacral spine. AJNR Am J Neuroradiol. 1983;4:609–610.PubMedGoogle Scholar
  106. 106.
    Taylor VM, Deyo RA, Cherkin DC, Kreuter W. Low back pain hospitalization. Recent United States trends and regional variations. Spine (Phila Pa 1976). 1994;19:1207–1212; discussion 1213.Google Scholar
  107. 107.
    Tullberg T, Grane P, Rydberg J, Isacson J. Comparison of contrast-enhanced computed tomography and gadolinium-enhanced magnetic resonance imaging one year after lumbar discectomy. Spine (Phila Pa 1976). 1994;19:183–188.Google Scholar
  108. 108.
    Tullberg T, Isacson J, Weidenhielm L. Does microscopic removal of lumbar disc herniation lead to better results than the standard procedure? Results of a one-year randomized study. Spine (Phila Pa 1976). 1993;18:24–27.Google Scholar
  109. 109.
    Vaughan PA, Malcolm BW, Maistrelli GL. Results of L4-L5 disc excision alone versus disc excision and fusion. Spine (Phila Pa 1976). 1988;13:690–695.Google Scholar
  110. 110.
    Vucetic N, de Bri E, Svensson O. Clinical history in lumbar disc herniation. A prospective study in 160 patients. Acta Orthop Scand. 1997;68:116–120.CrossRefPubMedGoogle Scholar
  111. 111.
    Walker J. Folk Medicine in Modern Egypt: Being the Relevant Parts of the Tibb al-Rukka, or, Old Wives’ Medicine. London, UK: Luzac; 1934.Google Scholar
  112. 112.
    Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine (Phila Pa 1976). 1983;8:131–140.Google Scholar
  113. 113.
    Wegner I, Widyahening IS, van Tulder MW, Blomberg SEI, de Vet HCW, Brønfort G, Bouter LM, van der Heijden GJ. Traction for low-back pain with or without sciatica. Cochrane Database Syst Rev. 2013;8:CD003010Google Scholar
  114. 114.
    Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Hanscom B, Skinner JS, Abdu WA, Hilibrand AS, Boden SD, Deyo RA. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA. 2006;296:2441–2450.CrossRefPubMedCentralPubMedGoogle Scholar
  115. 115.
    Weir BK, Jacobs GA. Reoperation rate following lumbar discectomy. An analysis of 662 lumbar discectomies. Spine (Phila Pa 1976). 1980;5:366–370.Google Scholar
  116. 116.
    Williams RW. Microlumbar discectomy: a conservative surgical approach to the virgin herniated lumbar disc. Spine (Phila Pa 1976). 1978;3:175–182.Google Scholar
  117. 117.
    Wilson DH, Harbaugh R. Microsurgical and standard removal of the protruded lumbar disc: a comparative study. Neurosurgery. 1981;8:422–427.CrossRefPubMedGoogle Scholar
  118. 118.
    Wiltse LL. Surgery for intervertebral disk disease of the lumbar spine. Clin Orthop Relat Res. 1977;129:22–45.CrossRefPubMedGoogle Scholar
  119. 119.
    Yasargil MG, Vise WM, Bader DC. Technical adjuncts in neurosurgery. Surg Neurol. 1977;8:331–336.PubMedGoogle Scholar

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© The Association of Bone and Joint Surgeons® 2014

Authors and Affiliations

  1. 1.Seton Spine & Scoliosis Center, A Program of the Seton Brain and Spine InstituteUniversity Medical Center at BrackenridgeAustinUSA

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