Skip to main content

Fragment excision versus conventional disc removal in the microsurgical treatment of herniated lumbar disc

Summary

100 patients who had a lumbar microdiscectomy were retrospectively compared with 100 microsurgically treated patients who had only a removal of the herniated disc fragment. We were able to show that there are less “reherniations” in the fragment removal group and the clinical outcome is often better regarding postoperative problems of instability.

This is a preview of subscription content, access via your institution.

References

  1. Aldrich F (1990) Posterolateral microdiscectomy for cervical monoradiculopathy caused by posterolateral soft cervical disc sequestration. J Neurosurg 72: 370–377

    PubMed  Google Scholar 

  2. Balderston RA, Gilyard GG, Jones AAM, Wiesel SW, Spengler DM, Bigos SJ, Rothmann RH (1991) The treatment of lumbar disc herniation: simple fragment excision versus disc space curettage. J Spinal Disord 4: 22–25

    PubMed  Google Scholar 

  3. Caspar W (1977) A new surgical procedure for lumbar disc herniation causing less tissue damage through a microsurgical approach. Adv Neurosurg 4: 74–77

    Google Scholar 

  4. Caspar W, Campbell B, Barbier DD, Kretschmer R, Gotfried Y (1991) The Caspar microsurgical discectomy and comparison with a conventional standard lumbar disc procedure. Neurosurgery 28: 78–86

    PubMed  Google Scholar 

  5. Ebeling U, Kalbarcyk H, Reulen HJ (1989) Mikrochirurgische Zweiteingriffe nach lumbaler Bandscheibenoperation. Nervenarzt. 60: 553–558

    PubMed  Google Scholar 

  6. Ebeling U, Reichenbach W, Reulen HJ (1986) Results of microsurgical lumbar discectomy. Acta Neurochir (Wien) 81: 45–52

    Google Scholar 

  7. Fankhauser D, de Tribolet N (1987) Extreme lateral lumbar disc herniation. J Neurosurg 1: 111

    PubMed  Google Scholar 

  8. Faulhauer K, Sahebdjami S (1994) Erfahrungen mit der mikrochirurgischen zervikalen Foraminotomie. In: Matzen KA (ed) Die operative Behandlung der Halswirbelsäule. Zuckschwerdt, München, pp 79–81

    Google Scholar 

  9. Goald HJ (1980) Microlumbar discectomy: follow-up of 477 patients. J Microsurg 2: 95–100

    PubMed  Google Scholar 

  10. Kaelin A (1991) Schmerzrezidive nach Eingriffen an der Lendenwirbelsäule. In: Benini A (ed) Die degenerative Instabilität der Lendenwirbelsäule. Huber, Bern, pp 75–79

    Google Scholar 

  11. Kotilainen E, Valtonen S, Carlson C-A (1993) Microsurgical treatment of lumbar disc herniation: follow-up of 237 patients. Acta Neurochir (Wien) 120: 143–149

    Google Scholar 

  12. Krupp W, Schattke H, Müke R (1994) Technik und Resultate dorsaler Operationen lateraler zervikaler Bandscheibenvorfälle. In: Matzen KA (ed) Die operative Behandlung der Halswirbelsäule. Zuckschwerdt, München, pp 87–91

    Google Scholar 

  13. McCulloch JA (1989) Principles of microsurgery for lumbar disc disease. Raven, New York

    Google Scholar 

  14. Morscher E (1991) Lumbale Instabilität: Definition und Ursachen. In: Benini A, Magerl F (eds) Die degenerative Instabilität der Lendenwirbelsäule. Huber, Bern, pp 24–33

    Google Scholar 

  15. Naggar L, Fankhauser H, Maeder P (1989) Instabilität nach unilateraler Foraminektomie für extrem laterale Diskushernie. In: Benini A (ed) Komplikationen und Misserfolge der lumbalen Diskus-Chirurgie. Huber, Bern, pp 83–86

    Google Scholar 

  16. Pappas CTE, Harrington T, Sonntag VKH (1992) Outcome analysis in 654 surgically treated lumbar disc herniations. Neurosurgery 30

  17. Paris SV (1985) Physical signs of instability. Spine 10: 277

    PubMed  Google Scholar 

  18. Prolo DJ, Oklund SA, Butcher M (1986) Toward uniformity in evaluating results of lumbar spine operations. A paradigm applied to posterior lumbar interbody fusions. Spine 11: 601–606

    PubMed  Google Scholar 

  19. Reulen HJ, Pfaundler S, Ebeling U (1987) The lateral microsurgical approach to “extracanalicular” lumbar disc herniation. Acta Neurochir (Wien) 84: 64–67

    Google Scholar 

  20. Rogers LA (1988) Experience with limited versus extensive disc removal in patients undergoing microsurgical operations for ruptured lumbar discs. Neurosurgery 22: 82–85

    PubMed  Google Scholar 

  21. Ruflin G (1989) Instabilität des operierten Bewegungssegmentes nach der lumbalen Diskus-Chirurgie. In: Benini A (ed) Komplikationen und Misserfolge der lumbalen Diskus-Chirurgie. Huber, Bern, pp 66–82

    Google Scholar 

  22. Siebner HR, Faulhauer K (1990) Frequency and specific surgical management of far lateral lumbar disc herniations. Acta Neurochir (Wien) 105: 124–131

    Google Scholar 

  23. Silvers HR (1988) Microsurgical versus standard lumbar discectomy. Neurosurgery 22: 837–841

    PubMed  Google Scholar 

  24. Spengler DM (1982) Lumbar discectomy. Results with limited disc excision and selective foraminotomy. Spine 7: 604–607

    PubMed  Google Scholar 

  25. Steinsiepe EKF, Rohner M (1989) Der extraforaminale Zugang zur extrem lateralen Diskushernie. In: Benini A (ed) Komplikationen und Misserfolge der lumbalen Diskus-Chirurgie. Huber, Bern, pp 109–121

    Google Scholar 

  26. Striffeler H, Gröger U, Reulen HJ (1991) “Standard” microsurgical lumbar discectomy versus “conservative” microsurgical discectomy, a preliminar study. Acta Neurochir (Wien) 112: 62–64

    Google Scholar 

  27. Vaughan PA, Malcolm BW, Maistrelli GL (1988) Results of L4-L5 disc excision alone versus disc excision and fusion. Spine 13: 690

    PubMed  Google Scholar 

  28. Williams RW (1978) Microlumbar discectomy. A conservative surgical approach to the virgin herniated lumbar disc. Spine 3

Download references

Author information

Authors and Affiliations

Authors

Additional information

Dedicated to our former teacher Prof. Fritz Loew, Chief-Editor emeritus of Acta Neurochirurgica.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Faulhauer, K., Manicke, C. Fragment excision versus conventional disc removal in the microsurgical treatment of herniated lumbar disc. Acta neurochir 133, 107–111 (1995). https://doi.org/10.1007/BF01420059

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01420059

Keywords

  • Lumbar disc surgery
  • fragment excision
  • conventional
  • disc removal
  • postoperative instability