A critique of the surgical management of lumbar disc disease in a private neurosurgical practice.

The magnitude of the lumbar disc problem is reviewed and a profile of medical and surgical therapeutic expectations is presented. A study of a 5-year epoch of a neurosurgical practice indicated that 64% of all patients requiring disc surgery had satisfactory results and 12% were frank failures. The younger patients with single level disc rupture had the best results, and 18% of all patients required further surgery for recurrent disc problems. The complication rate was 4%. The bias of compensation invalidates any critique of a therapy mode and creates a tremendous economic impact. The need for improvement in the surgical management of lumbar disc disease is established.