Post-operative long-term results of lumbar disc herniation

The purpose pf this paper is to clarify the relationship between clinical results and radiographic changes in long term follow-up after osteoplastic laminectomy for lumber disc herniation. Ninety-six patients with lumber disc herniation who had been treated surgically were able to followed up fpr more than 5 years up to 20 years (average 11 years). There were 78 patients who had been treated by osteoplastic laminectomy and 18 patients by partial laminotomy. Following results were obtained : 1. In osteoplastic cases, the long term results were excellent in 48 cases (62%), good in 19 cases (24%), fair in 10 cases (13%), poor in case (1%). On the other hand, in partial laminotomy cases, the long term results were excellent in 11 cases (61%), good in 4 cases (22%), fair in 3 cases (17%). There was no significant difference in two operative methods. 2. In relationship between postperative clinical results and the follow-up X-rays, generally clinical reslts were not in relationship of the involved disc height, while it seemed probable that stable narrowed disc was not seen transition of the resuluts. In addition, the results was not in relationship of range of lumber motion and posterior spur fprmation. The narrower the saggital diametter of the L4 canel was, the poorer the clinical results were. 3. From this study it would seem that osteoplastic laminectomy is enough to produce long term satisfactory results in a high percentage of patients with lumber disc herniation. This method is more effective in special cases than partial laminotomy. Better results should be obtained by considering cleverly osteoplastic laminectomy and partial laminectomy.