A Clinical Study of Intervertebral Disc Surgery Based on 1500 Cases.

Kim, Young Soo

Original Article

Journal of Korean Neurosurgical Society 1973;2(1): 71-82.

Department of Neurosrgery, Severance Hospital Yonsei University College of Medicine, Korea.

ABSTRACT

Intervertebral disc disease, encountered in term of its life history, represents on of the most complexing medicosurgical disorders. The discovery by Mixter and Barr in 1934, that an intraspinal protrusion of the intervertebral disc was sometimes the cause of lumbago and sciatica, was outstandingly important because it might proved a rational for the treatment of backache. The author has reviewed 1500 cases of disc surgery performed at Yonsei University, Sceverance Hospital from 1950 to 1971. A contrast myelography was carried out routineley and the day was attempted to remove as much as possible. Surgical treatment was underwent by laminectomy, partial hemi-or total, for the thoracic and lumbar discs and Cloward's anterior approach for cervical discs invariably. CONCLUSION: 1. Among the 1500 disc surgeries 90.2% were lumbar disc lesions; thoracic 0.1% and cervical 9.7%. The percentile of disc herniation between L4-5 verebrae was 62%; 27% between L5-S1 vertebrae. 24% of lumbar intervertebral disc herniations disclosed multiple lesion. C5-6 disc herniation was 58% and C6-7 lesion 27%, multiple cervical disc herniation was 27%. 2. A contrast myelography is an invaluable procedure for the diagnosis of a herniation of the nucleus pulposus. It is a considerably safe procedure with minimal complication when performed carefully. 3. For a central disc herniation surgical approach from both sides may preferably render a better result. 4. In case when the nucleus pulposus being protruded way laterally a decompression of the nerve root is mandatory in the foraminal and the disc interspace. 5. The posterior approach for the thoracic disc herniation may render a considerable damage to the spinal cord with subsequent paraparesis. The anterolateral or posterolateral procedure may give a better result. 6. 97.7% of lumbar disc surgery disclosed from an improvement to recovery. 7. The anterior approach for the cervical intervertebral discs gives a better result; 98% of the surgeries disclosed an improvement to recovery.