Operative methods are changing from aggressive open methods to less invasive methods including microscopic discectomy and various kinds of percutaneous methods. In spite of having definite advantages, percutaneous methods still have limited indications and no uniformly convincing clinical results. Microscopic discectomy has advantages of those of open methods and percutaneous methods. A review of clinical results of operative treatment for lumbar disc herniation shows favorable long-term results. For the better long-term results, we should understand the proper indications of each treatment modalities.
Diskectomy

No abstract available.
Diskectomy*

Thepercutaneous treatmentof lumbardisc diseasewithlaser energyhas recently emerged as an alternative to standard open surgery or mechanical percutaneous methods. The indications of percutaneousendoscopic laser discectomy should, however, be well evaluated according to clinical and morphological criteria. We report three cases of herniated lumbar disc treated with conventional open surgery after the failure of laser discectomy.
Diskectomy*

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

OBJECTIVES: The purposes of this study were to 1) develope web-based information program for the patients undergoing lumbar discectomy, and 2) test the effectiveness of web-based information program for improving patients knowledge level on lumbar discectomy. METHODS: First, to improve the validity of contents of web-based program, the information needs were identified from 30 patients admitted for lumbar discectomy and experts' validation of preliminary contents of program was performed. Second, satisfaction level of the developed program was measured by 15 experts and 20 patients. Finally, the outcome of web-based program was compared by each of 20 lumbar discectomy patients allocated to experimental group (EG) and control group(CG) in term of knowledge level. RESULTS: The web-based program was developed with 24 screens categorized 6 categories. Satisfaction scores on information relevance and information usefulness of experts were higher than those of patients. The EG's scores on knowledge level was significantly higher than those of CG. CONCLUSIONS: We can conclude that web-based information program is more effective tool than the traditional education method to enhancing knowledge level. We suggest that various web-based programs for other patient groups expecting surgeries should be developed in order to satisfy the patients' needs more effectively.
Diskectomy ; Humans

OBJECTIVE: The purpose of this study was to evaluate the efficacy of a transforaminal suprapedicular approach, semi-rigid flexible curved probe, and 3-dimensional reconstruction computed tomography (3D-CT) with discogram in the endoscopic treatment of non-contained lumbar disc herniations. METHODS: The subjects were 153 patients with difficult, non-contained lumbar disc herniations undergoing endoscopic treatment. The types of herniation were as follows : extraforaminal, 17 patients; foraminal, 21 patients; high grade migration, 59 patients; and high canal compromise, 56 patients. To overcome the difficulties in endoscopic treatment, the anatomic structures were analyzed by 3D reconstruction CT and the high grade disc was extracted using a semi-rigid flexible curved probe and a transforaminal suprapedicular approach. RESULTS: The mean follow-up was 18.3 months. The mean visual analogue scale (VAS) of the patients prior to surgery was 9.48, and the mean postoperative VAS was 1.63. According to Macnab's criteria, 145 patients had excellent and good results, and thus satisfactory results were obtained in 94.77% cases. CONCLUSION: In a posterolateral endoscopic lumbar discectomy, the difficult, non-contained disc is considered to be the most important factor impeding the success of surgery. By applying a semi-rigid flexible curved probe and using a transforaminal suprapedicular approach, good surgical results can be obtained, even in high grade, non-contained disc herniations.
Diskectomy ; Diskectomy, Percutaneous ; Follow-Up Studies ; Humans

Repeated surgery of the lumbar spine after lumbar discectomy was not uncommon. Total 817 cases of lumbar disorders were carried out surgical intervention in author's clinic from Jan. 1993. to May 1997. Among them, 82 cases were reoperated cases after lumbar disc surgery. The causes, methods and outcome of reoperation were reviewed. The most common causes of reoperation was epidural adhesion, and the most frequent method of reoperation was the interbody fusion with adhesiotomy. Epidural fibrosis was the major problem and must be studied forward for preventing reoperaion.
Diskectomy ; Fibrosis ; Reoperation* ; Spine