Development of degenerative spondylosis of the lumbar spine after partial discectomy. Comparison of laminotomy, discectomy, and posterolateral discectomy.

Study Design: The development of degenerative spondylosis after successful operative decompression of the affected nerve root was prospectively evaluated in a comparative case series of 100 patients with a herniated lumbar nucleus pulposus.

Objectives: The objective of this study was to compare the relative incidence of degenerative spondyloarthrosis after successful posterior laminotomy and discectomy and posterolateral extradural discectomy for decompression of a compromised lumbar nerve root.

Summary Of Background Data: The relationship between the radiographic appearance of degenerative spondylosis and prior operative procedures has been controversial and at times contradictory.

Arthroscopic microdiscectomy of the lumbar spine.

Disc herniation in athletes is uncommon; however, it requires prompt diagnosis and treatment. Arthroscopic microdiscectomy is associated with minimal postoperative morbidity and it is particularly suitable for the surgical treatment of unremitting radiculopathy associated with herniated lumbar disc in athletes. The addition of the arthroscope and the deflecting instruments allows for visualization, identification, and extraction of posterior and posterolateral collagenized nuclear fragments that are believed to be the common cause of nerve root compression and sciatica following disc herniation.

Arthroscopic microdiscectomy.

Follow-up examinations performed a minimum of 2 years postoperatively showed that no neurovascular complications developed in 100 patients who underwent arthroscopic microdiscectomy for treatment of herniated discs at L3-4, L4-5, or L5-S1. By using a posterolateral approach, endoscopic control, and specially designed straight, upbiting, and deflectable forceps, it was possible to remove not only fragments located in the center of the nucleus, but also fragments that had migrated posteriorly and posterolaterally. Analysis of operative results by a modification of the Rush-Presbyterian-St.

Annular protrusion: pathophysiology and roentgenographic appearance.

The degenerative changes of the lumbar spine in 100 patients with symptomatic low-back pain were reviewed using plain roentgenograms and computed tomographic scans in order to determine the relationship between degeneration and annular protrusion. Additionally, the lumbar spinal units of 25 fresh cadavers were roentgenographed, injected with a mixture of methylene blue and renografin-60, dissected, and studied. The state of degeneration of each of the intervertebral units of both groups was graded on a four-point scale based on the roentgenographic presence or absence of osteophytes and facet joint changes, and the intervertebral disc height.