Treatment of the isolated lumbar intervertebral disc herniation: microdiscectomy versus chemonucleolysis

A long-term goal of spine surgeons has been to reduce the morbidity, cost, and recuperative period of primary lumbar disc surgery. In this paper, microdiscectomy and chemonucleolysis are evaluated and compared with respect to achieving these goals. Two groups of successive, noncompensation patients numbering 50 each were studied. All patients met standard clinical and imaging criteria for an isolated lumbar vertebral disk herniation. One group was treated with chemonucleolysis and the second with micodiscectomy. Average follow-up exceeded 3 years. While both treatment groups achieved the stated goal when compared with traditional laminectomy, the microdiscectomy groups demonstrated statistically superior treatment results, with reduced time to return to work, and fewer required subsequent surgical procedures.