Brunori A, De Caro G M, Giuffrè R
Dipartimento di Neuroscienze, Ospedale San Camillo, Roma.
Ann Ital Chir. 1998 May-Jun;69(3):285-93.
Although the clinical picture of discogenic sciatica is well known already in the ancient world, it is not until 1933 that WJ Mixter and JS Barr provide the correct pathogenetic interpretation and suggest surgery as the treatment of choice. The work of the American Authors was however based on the knowledge acquired during the previous centuries starting with Domenico Cotugno, who first suggested the neurogenic nature of sciatica (1764) and later with the neurologists of the french school Valleix, Lasègue, Dejerine, Sicard who elucidated the semeiology and debated in detail the etiopathogenesis of the condition. The german pathologists Schmorl and Andrae (1927-29) are to be credited for their contribution to the pathology of intervertebral disc, recognizing the frequency and degenerative (not neoplastic) nature of nucleus pulposus herniation. Surgery of disc herniation starts with Oppenheim and Krause (1909). Mixter and Barr used laminectomy and a transdural route although a more limited approach to the spinal canal had already been proposed by the italian Bonomo (1902), unknown to many. Love, of the Mayo Clinic (1937-39) introduced the extradural/interlaminar approach while Caspar and Yasargil (1977) applied the concepts of microsurgery to the procedure. The latest advances are represented by percutaneous and endoscopic techniques.
尽管椎间盘源性坐骨神经痛的临床症状在古代就已为人所知，但直到1933年，WJ·米克斯特和JS·巴尔才给出了正确的发病机制解释，并建议将手术作为首选治疗方法。然而，这两位美国作者的工作是基于此前几个世纪所积累的知识，最早可追溯到多梅尼科·科图尼奥，他首次提出了坐骨神经痛的神经源性本质（1764年），后来法国学派的神经学家瓦莱克斯、拉塞格、德热里纳、西卡尔等人进一步阐明了该病的症状学，并详细讨论了其病因发病机制。德国病理学家施莫尔和安德雷（1927 - 1929年）对椎间盘病理学做出了贡献，他们认识到髓核突出的频率及其退行性（而非肿瘤性）本质。椎间盘突出症的手术始于奥本海姆和克劳斯（1909年）。米克斯特和巴尔采用了椎板切除术和经硬膜途径，尽管意大利的博诺莫（1902年）早已提出了一种对椎管更为有限的手术方法，但很多人并不知晓。梅奥诊所的洛夫（1937 - 1939年）引入了硬膜外/椎板间入路，而卡斯帕和亚萨吉尔（1977年）将显微外科概念应用于该手术。最新进展体现在经皮和内镜技术上。
