[Aneuralgic root paralyses caused by lumbar intervertebral disk displacement. Follow-up of surgical therapy]

It is a controversial issue whether or not a painless paralysis caused by a lumbar disc herniation should be managed surgically because of the possible fatal destruction of the nerve root. In a retrospective study we examined 46 patients concerning the reversibility of their neurological deficits. Our results show that the so called "aneuralgic state" of the lumbar root compression syndrome and the death of the nerve root are not identical. More than half of the patients with the symptoms of nerve root death gained significant improvement above their preoperatively existing paralysis sometimes even up to several years later. The appearance of the compressed root at the time of surgery is of special importance because it allows conclusions concerning the remission of preexisting paresis. Defects of sensibility or the reflex status never improved without simultaneous improvement of paresis. The damage of the nerve root due to disc herniation is discussed with the help of literature sources with special consideration as to the time of reinnervation. Our results demonstrate that patients with an "aneuralgic state" can benefit from disc surgery and thus surgery could be recommended for these patients. Two cases are described.