Differential therapy of lumbar intervertebral disk protrusion
Mayer, H.M.; Brock, M.
Zentralblatt für Chirurgie 114(8): 489-502
1989
ISSN/ISBN: 0044-409X PMID: 2662681 Document Number: 329703
Surgical treatment for protrusion of intervertebral disks in the lumbar region has been considerably optimised. Progress in imaging techniques has enabled representation and recording of intervertebral disk disorders at various pathogenetic stages. Backache has become endemic in industrial countries, in the course of time, and is often accompanied by pseudoradicular ischialgia. It is quite often uncritically attributed to intervertebral disk damage on the basis of findings recorded from computed tomography. With patients increasingly suffering pain, this has in many cases led to rash surgical decisions. -Principles of differential diagnosis by which the complexity of morphological findings underlying clinical symptoms is taken into due consideration are absolutely necessary to counter the above developments. Indications for neurosurgical differential therapy for protrusion of intervertebral disks at lumbar level should be individually established with due consideration of therapeutic procedures available and of the severity of complaints. The percutaneous and microsurgical techniques described in this paper are likely to suggest that procedures, such as hemilaminectomy and laminectomy are no longer justified unless exceptional cases are to be handled.