Experience of microsurgical compared with conventional technique in lumbar disc operations.

Experiences gained from the first 56 patients operated upon for lumbar disc herniation by the microsurgical technique in our clinic are presented. The results are compared with those of conventional operations performed by the author and a senior colleague. Compared with the traditional operation the microsurgical approach meant a shorter duration of operation, less bleeding during surgery, less post-operative wound pain, a shorter post-operative stay in hospital and return to work within half the usual time. Six months after operation 96% of the patients treated by the microsurgical technique were relieved of their root pain and 89% were free from low back pain. The corresponding figures at follow-up 3.6 years post-operatively were 89% and 80% respectively. Compared with the results of the present and previous series of conventional operations, this means a high degree of success. Restitution of pre-operative neurological impairment was complete in 90% of the patients at 6 months. There were no haemorrhagic complications, infections or increased neurological disturbances following microsurgery. Microanatomical examinations revealed capsule formation around prolapsed sequestra with time and adherence to the nerve root, which are considered to be foreign body reactions. In conclusion, microsurgery has proven to be a safe, non-traumatic procedure in the removal of lumbar disc herniations, with very good long-term results.