Percutaneous lumbar disc excision: experience with sixty cases and review of the literature

A series of 60 cases of percutaneous disc excisions is presented. There were 43 males and 17 females with an average age of 36 years. All cases were failures of conservative treatment and were disabled for their usual occupation. Results were excellent or good in 44 cases, satisfactory in four and failures in eight. There was no postoperative complication. The importance of a complete radiologic workup is emphasized. The cost/benefit and risk/benefit ratios of this operation compare favorably with conventional open laminectomy. The procedure is best indicated in younger patients with good distal water content and contained herniated lumbar disc. It is contraindicated in patients with a free fragment and in patients with previous surgery at the same level.