Complications in the first 40 cases of microdiscectomy

From 1984 to 1986, a single surgeon treated 40 patients suffering from lumbar disc herniation by the technique of microdiscectomy. While the advantages of working under magnification are endorsed, the complications encountered are analysed with the aim of giving warning to surgeons keen to start the technique. The complications included intraoperative dural tears (two cases), discitis (two cases), and recurrence of back pain (two cases). The intraoperative dural damage did not require specific treatment, while the patients with discitis responded readily with antibiotics. The recurrent cases were found to be caused by adhesion bands produced by hanging tags of incompletely removed yellow ligament. It is therefore concluded that in microdiscectomy prophylactic antibiotics should be given and a complete removal of the yellow ligament on the side of surgery should be ensured to avoid infection and recurrent root impingement.