title: Microsurgery in the treatment of crural and sciatic pain due to disc and bone compression: considerations on the first 100 cases.
abstract: The authors present the results they obtained in the first 100 operations performed between January 1989 and November 1990 for the treatment of lumbar sciatic pain related to disc and/or bone compression: microsurgery according to the Caspar method was used. A total of 113 spaces were submitted to surgery; discectomy at two levels was performed in 13 patients. Nerve root compression observed was based on three causes: 1) pure disc hernia (57.5%), 2) pure lateral stenosis (15.9%), 3) combined pathology (hernia+stenosis) (25.6%). In one of the cases the pathology remained unknown. At an average two-year follow-up there were 94 excellent or good results, 2 fair results, and 4 poor results. Complications included dural lacerations in 3 cases, with no sequelae. Eight patients were submitted to further surgery for recurrence of symptoms; the final results after reintervention were excellent in 7 cases, and fair in 1. The authors emphasize the advantages to using microsurgery as compared to macrosurgery, and stress a frequent finding of pure lateral stenosis or associated with disc pathology (47 out of 113 levels operated, equal to 41%), as well as the reliability of CT scan when dealing with disc pathology (97% positive diagnosis) but its unreliability when diagnosis is lateral stenosis (19 out of 47, equal to 40%).
authors.affiliation: Divisione di Ortopedia e Traumatologia, Ospedale Ceccarini, Riccione.
authors.forename: G
authors.initials: G
authors.lastname: Baccarani
authors.forename: E
authors.initials: E
authors.lastname: Brunetti
authors.forename: R
authors.initials: R
authors.lastname: Meringolo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000150:complications / Q000601:surgery; D012008:Recurrence; D012074:Remission Induction; D012585:Sciatica / Q000209:etiology / Q000601:surgery*; D013126:Spinal Nerve Roots