Surgery of the lumbar intervertebral disc. Results of a personal minimal technique

Surgery of the intervertebral disc, despite its relative simplicity, has a high failure rate at the functional level. There is often severe residual pain which is a real problem because it is so difficult to treat either the symptom or its cause. We report the results of 122 procedures in 100 patients, some of whom had multiple lesions, using a technique (already described in a preliminary paper) consisting of an interlaminar approach modified to provide greater preservations of neural, bony and joint structures. The results were very good, both soon after operation and at later follow-up (between six months and five years). There were no cases of recurrence or pseudo-recurrence, one case of contralateral recurrence (cured by further operation) and a very low incidence of residual backache. These results confirm that, provided the patients have been well selected so that not every patient with lumbar backache is operated on but only those with proven disc lesions, operation does fundamentally influence the quality of the results.