The classic. Exposure of ruptured lumbar discs: a technical discussion

Technical problems in disc surgery are discussed. Hypotension keeps bleeding under control while surgery is in progress and offers a good view of the exposed area. Hypotension protects against postoperative haematoma. The approach must limit damage to important functional elements. By making the incision in the dorsal fascia lateral to the spinous processes and closing the wound with the spine flexed, postoperative tightness is less pronounced. Extensive disc removal protects against disc material being squeezed out when early weightbearing is permitted. The patient is allowed to leave bed the day after surgery. No physiotherapy, no support, no fusion are needed.