Percutaneous posterolateral lumbar discectomy. An alternative to laminectomy in the treatment of backache and sciatica.
The evacuation and decompression of the herniated lumbar disc (HLD) through a sheath or cannula inserted dorsolaterally represent a new concept in the treatment of backache and sciatica associated with disc herniation. Under local anesthetic and Valium (Roche, Nutley, New Jersey) sedation, 20 patients with sciatica, restricted straight-leg raising, and neurological impairment were treated by this simple and safe technique. All patients had computed tomographic evidence of L4-L5 protrusion. The introduction of a sheath with an internal diameter of 4.9 mm permitted removal of the nuclear material by means of a small pituitary forcep. Using the self-assessment method of Coventry and Stauffer, it was concluded that 12 of the 20 patients had a good or fair result. Predictably, the compensation patients fared poorly. There were no complications. This technique appears applicable in HLD to properly selected patients, and it would seem that it is safe, effective, and cost efficient.
Graham
C E
CE
Orthopaedic Department, VMO Prince of Wales Hospital, Randwick, Sydney, Australia.
D000328:Adult; D001416:Back Pain / Q000209:etiology; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D011379:Prognosis; D012585:Sciatica / Q000209:etiology