The knee--elbow position in lumbar disc surgery: a review of complications

Follow-up studies were carried out in 1962, 1977, and 1981 on 35% or 943 or our 2690 patients operated upon from 1950 through 1981 for lumbar disc herniation. Seven hundred and twenty-four were done with and 1848 without spinal fusion. There were 11.2% operative, 8.3% postoperative and 18.9% late complications. Sepsis occurred in 2 patients (0.2%). Thrombosis decreased from 10% in the 1950s to 4% in the 1960s and to zero in the late 1970s. Reoperations were performed in 10.8% of the fused and in 23.6% of the nonfused patients. There were no serious vascular injuries and no postoperative deaths. Serious complications from lumbar disc surgery with the patient in the knee--elbow position occur rarely and ought to be avoided. Posterior spinal fusion seems to give better protection against recurrence of pain than simple removal of the herniated disc material.