Intervertebral Disc Material Gained by Percutaneous Discectomy

Abstract

Considering the vast number of patients operated upon for protruded or herniated lumbar discs, there is comparatively little literature available on the pathology of these structures. One reason for this is that the material gained at surgery is not routinely screened by a pathologist in many neurosurgical centers unless it is of unusual appearance to the surgeon; the rationale being that 1. disc morphology has no immediate clinical relevance, and 2. current in vivo imaging techniques allow early preoperative recognition of lesions other than degenerative disc pathology. Although the latter point is in line with our experience of the past 10 years, surprising pathological findings do occur occasionally, a fact that is well documented in recent literature [4, 5]. Furthermore, Beatty recently suggested the syndrome of myxomatous degeneration, a distinct entity from fibrotic disc degeneration of herniated nucleus pulposus [3]. This condition cannot be diagnosed other than by pathological screening. The popularity of chemonucleolysis has also led to renewed interest in intervertebral disc disease [1].