[A clinical and radiological study of posterior nucleotomy for lumbar disc herniation-a review after ten to twenty-five years].
This study was performed to clarify long-term results of posterior nucleotomy and to investigate the clinical factors which affect the end results. Sixty patients with lumbar disc herniation who underwent posterior nucleotomy at the Chiba University Hospital from October, 1954 to December, 1968 were completely reviewed. Fifty-six patients were clinically examined personally, and four patients by questionnaire. Their follow-up period ranged from 10 to 25 years, with an average 17.8 years. They consisted of 41 light, 9 moderate, and 10 heavy manual laborers. The results were as follows: 1) Over-all clinical results were excellent in 19 (32%), good in 32 (53%), fair in 5 (8%), and poor in 4 cases (7%). 2) Preoperative sciatica was completely relieved in 80 percent and straight leg raising test became negative in 88 percent. However, backache was completely relieved only in 38 percent, sensory disturbance in 43 percent, and numbness in 45 percent. 3) Generally, the follow-up X-rays showed stable narrowed intervertebral space at operated level in patients with satisfactory clinical results, while unstable and severely narrowed intervertebral space was seen in some patients with unsatisfactory clinical results. 4) Lumbar adhesive arachnoiditis was found in one fair and two poor cases. Operative trauma was thought to be one of their etiologic factors. Residual symptoms after posterior nucleotomy appeared to be correlated with this operative trauma.
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000601:surgery*; D007796:Laminectomy / Q000379:methods*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009192:Myelography; D013997:Time Factors