Related Experiment Videos
[Surgery of lumbar disk hernia: historical perspective]
A Brunori1, G M De Caro, R Giuffrè
1Dipartimento di Neuroscienze, Ospedale San Camillo, Roma.
Annali Italiani Di Chirurgia
|December 3, 1998
Summary
Discogenic sciatica, known since antiquity, was pathogenetically explained in 1933. Surgical interventions evolved from laminectomy to minimally invasive percutaneous and endoscopic techniques.
Area of Science:
- Neurology
- Neurosurgery
- Spinal Surgery
Background:
- Discogenic sciatica has been clinically recognized since ancient times.
- Early contributions by Cotugno and French neurologists elucidated sciatica's neurogenic nature and pathogenesis.
- German pathologists Schmorl and Andrae identified nucleus pulposus herniation as degenerative.
Observation:
- W.J. Mixter and J.S. Barr provided the definitive pathogenetic interpretation in 1933, advocating surgery.
- Oppenheim and Krause initiated surgical treatment for disc herniation in 1909.
- Early surgical approaches included laminectomy and transdural routes, with Bonomo proposing a limited approach.
Findings:
- Love introduced extradural/interlaminar approaches (1937-39).
- Caspar and Yasargil applied microsurgery principles (1977).
- Current advancements include percutaneous and endoscopic techniques.
Implications:
- The historical progression highlights the evolution of understanding and treating discogenic sciatica.
- Advancements in surgical techniques have led to less invasive and more effective treatments.
- Continued innovation in spinal surgery promises improved patient outcomes for sciatica.