Experience with limited versus extensive disc removal in patients undergoing microsurgical operations for ruptured lumbar discs.

Of 68 patients undergoing microsurgical operations for ruptured lumbar discs, 33 were treated by removing only the herniated fragments. In the remaining 35, an attempt was made to remove the entire disc. No recurrences followed the more extensive discectomies during follow-up periods varying from 11 to 30 months. Seven recurrences followed operations in which only the offending fragment was removed (recurrence rate of 21%), four within 6 months. Among 68 patients treated by conventional neurosurgical techniques, there was only one recurrence during follow-up periods of at least 4 years. None of the operations was clearly superior in relieving leg pain, but microsurgically treated patients spent less time in the hospital and returned to work more quickly.