Surgical management of lumbar disc disease

The normal and pathologic anatomy and biochemistry of lumbar disc disease have been discussed. The use of various diagnostic modalities to support the clinical diagnosis has been assessed. Details of a conservative care program are outlined. A discussion of surgical indications and techniques for laminectomy, reoperative laminectomy, and posterolateral spinal fusion is also presented. The use of chymopapain is briefly described in anticipation of its imminent usage.