[Disk curettage in inveterate lumbago. Recent results in 45 cases]

Forty-five cases of intractable discogenic low back pain without sciatica were treated by curettage of the disc without grafting. One disc was curetted in 23 cases, two disc in 22 cases. The results are very good in 23 cases, good in 19 cases, and poor in 3 cases. The post-operative follow-up is between 1 and 2 years in 19 cases, 2 and 5 years in 13 cases, and more than 5 years in 13 cases. The length of follow-up and the number of discs curetted bear no relation to the quality of the result. In 8 cases a typical disc protrusion was found. In all other cases the appearance was different from that seen in the surgery of sciatica. Degeneration of the disc was a constant finding and presented various manifestations: simple protrusion, thickening of the posterior vertebral ligament, abnormal compressibility, and even an apparently normal disc, in which degeneration was only demonstrable after incision of the disc. Surgical exploration confirmed in early every case the data from discography. Radiodynamic examination after the operation showed a diminution in the mobility of the curetted disc, but perfect anatomical fusion is not necessary in order to obtain good results. The authors stress the necessity for great care in the selection of patients and in the operative technique.