Principles of Microsurgical Discectomy in Lumbar Disc Herniations

  • H. M. Mayer


The term “microsurgical discectomy” describes the removal of herniated parts of lumbar intervertebral discs through a posterior approach with the help of a surgical microscope and microsurgical instruments. It implies the application of general principles of microsurgery as well as the approach to the anatomical target area through a limited skin incision.


Nucleus Pulposus Disc Herniation Lumbar Disc Lumbar Disc Herniation Lumbar Intervertebral Disc 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Adson AW, Ott WO (1922) Results of the removal of tumors of the spinal cord. Arch Neurol Psychiatry (Chicago) 8: 520–538CrossRefGoogle Scholar
  2. 2.
    Andrews DW, Lavyne MH (1990) Retrospective analysis of microsurgical and standard lumbar discectomy. Spine 15: 329–335PubMedCrossRefGoogle Scholar
  3. 3.
    Berger A (1979) Operative Behandlung des lumbalen Bandscheibenvorfalles–Ergebnisse der Operation 1–20 Jahre danach. Inauguraldissertation, Univ. TübingenGoogle Scholar
  4. 4.
    Biehl G (1974) Subjektive Ergebnisbeurteilung bei 64o Bandscheibenoperationen aufgrund einer Fragebogenaktion. Z Orthop 112: 825–827PubMedGoogle Scholar
  5. 5.
    Biehl G, Peters G (1971) Behandlungsergebnisse bei 45o Bandscheibenoperationen. Z Orthop Ihre Grenzgeb 109: 836–847PubMedGoogle Scholar
  6. 6.
    Bushe KA, DeftereosT, Schäfer E (1968) Lumbago und Wurzelischialgie. Dtsch Med Wochenschr 93: 1171–1176CrossRefGoogle Scholar
  7. 7.
    Caspar W (1977) A new surgical procedure for lumbar disc herniation causing less tissue damage through a microsurgical approach. In: Wüllenweber R, Brock M (eds) Advances in Neurosurgery, vol 4. z pp 74–77Google Scholar
  8. 8.
    Caspar W (1986) Die mikrochirurgische OP-Technik des lumbalen Bandscheibenvorfalls. Empfehlungen zum Operationsablauf. Aesculap G, TuttlingenGoogle Scholar
  9. 9.
    Caspar W, Campbell B, Barbier DD, Kretschmer R, Gotfried Y (1991) The Caspar microsurgical discectomy and comparison with a conventional standard lumbar disc procedure. Neurosurgery 28: 78–87PubMedCrossRefGoogle Scholar
  10. 10.
    Chafetz NI, Genant HK, Moon KL, Helms CA (1983) Recognition of lumbar disc herniation with NMR. Am J Radiol 141: 1153–1156Google Scholar
  11. 11.
    Dandy WE (1929) Loose cartilage from intervertebral disk simulating tumor of the spinal cord. Arch Surg (Chicago) 19: 660–672CrossRefGoogle Scholar
  12. 12.
    Dauch WA (1986) Infection of the intervertebral space following conventional and microsurgical operations on the herniated lumbar intervertebral disc. A controlled clinical trial. Acta Neurochir (Wien) 82: 43–49CrossRefGoogle Scholar
  13. 13.
    De Deviti R, Spazinate R, Stella L, et al. (1984) Surgery of the lumbar intervertebral disc: results of a personal minimal technique. Neurochirurgia 27: 16–19Google Scholar
  14. 14.
    Ebeling U, Reulen HJ (1983) Ergebnisse der mikrochirurgischen lumbalen Bandscheibenoperation–Vorläufige Mitteilung. Neurochirurgia 26: 12–17PubMedGoogle Scholar
  15. 15.
    Ebeling U, Reulen HJ (1988) Mikrochirurgische Technik bei lumbalen Bandscheibenoperationen: Ist sie der konventionellen Methode überlegen? In: Jahrbuch der Neurochirurgie. Regensberg and Biermann, Münster, pp 143–160Google Scholar
  16. 16.
    Ebeling U, Reichenberg W, Reulen HJ (1986) Results of microsurgical lumbar discectomy. Review of 485 patients. Acta Neurochir (Wien) 81:45–52Google Scholar
  17. 17.
    Ferrer E, Garcia-Bach M, Lopez L, Isamat F (1988) Lumbar microdiscectomy: analysis of ioo consecutive cases. Its pitfalls and final results. Acta Neurochir Suppl (Wien) 43:39–43Google Scholar
  18. 18.
    Finneson BE (1978) A lumbar disc surgery predictive score card. Spine 3 /2: 186–188PubMedCrossRefGoogle Scholar
  19. 19.
    Frenkel H, Angehoefer I (1978) Frühergebnisse nach lumbalen Bandscheibenoperationen. Beitr Orthop Traumatol 25/9:523–528Google Scholar
  20. 20.
    Goald HI (1978) Microlumbar discectomy–Follow-up of 147 patients. Spine 3 /2: 183–185PubMedCrossRefGoogle Scholar
  21. 21.
    Goald HI (1979) Microsurgical removal of lumbar herniated nucleus pulposus. Surg Gynecol Obstet 149: 247–248PubMedGoogle Scholar
  22. 22.
    Goald HJ (1981) Microlumbar discectomy: follow-up of 477 patients. J Microsurg 2: 95–100CrossRefGoogle Scholar
  23. 23.
    Grubb SA, Libscomb HJ, Guilford WB (1987) The relative value of lumbar roentgenograms, metrizamide myelography and discography in the assessment of patients with low back syndrome. Spine 12: 282–286PubMedCrossRefGoogle Scholar
  24. 24.
    Hudgins WR (1983) The role of microdiscectomy. Orthop Clin North Am 14: 589–603PubMedGoogle Scholar
  25. 25.
    Jochheim KA, Loew F, Rütt A (eds) (1961) Lumbaler Bandscheibenvorfall. Springer, Berlin Göttingen HeidelbergGoogle Scholar
  26. 26.
    Kahanovitz N, Viola K, McCulloch JA (1989) Limited surgical discectomy and microdiscectomy–A clinical comparison. Spine 14: 79–81PubMedCrossRefGoogle Scholar
  27. 27.
    Keyl W, Kossyk W, Kuzmann J, Weigert M, Muzzulini B (1974) Ergebnisse lumbaler Nukleotomien aus den Berliner und Münchner Orthopädischen Kliniken. Z Orthop Ihre Grenzgeb 112: 798–801PubMedGoogle Scholar
  28. 28.
    Kho HC, Steudel D (1986) Vergleich der mikrochirurgischen lumbalen Bandscheibenoperationen mit der konventionellen Technik beim frei sequestrierten Bandscheibenvorfall. Eine retrospektive Studie anhand von 267 Fällen. Neurochirurgie 29: 181–185Google Scholar
  29. 29.
    Kotilainen E, Valtonen S, Carlson CA (1993) Microsurgical treatment of lumbar disc herniation: follow-up of 237 patients. Acta Neurochir (Wien) 120: 143–149CrossRefGoogle Scholar
  30. 30.
    Krämer J (1987) Das Postdiskotomiesyndrom-PDS. Z Orthop Ihre Grenzgeb125: 622–625Google Scholar
  31. 31.
    Love JG, Walsh MN (1938) Protruded intervertebral discs: report of ioo cases in which operation was performed. JAMA 111: 396–400CrossRefGoogle Scholar
  32. 32.
    Mayer G, Reiche P (1982) Ergebnisse der lumbalen Bandscheibenoperationen. Z Ärztliche Fortb (Jena) 76: 190–194Google Scholar
  33. 33.
    McCulloch JA (1989) Principles of microsurgery for lumbar disc disease. Raven Press, New YorkGoogle Scholar
  34. 34.
    McCulloch JA, Young PH (eds) (1998) Essentials of spinal microsurgery. Lippincott Raven, PhiladelphiaGoogle Scholar
  35. 35.
    Mixter WS, Barr IS (1934) Rupture of intervertebral disc with involvement of the spinal canal. New Engl J Med 211: 210–215CrossRefGoogle Scholar
  36. 36.
    Oldenkott P (1971) Zur medizinischen und medizinisch-sozialen Problematik beim lumbalen Bandscheibenvorfall. Habilitationsschrift, TübingenGoogle Scholar
  37. 37.
    Oldenkott P (1979) Mikrochirurgische Behandlung lumbaler Wurzelkompressionssyndrome. Med Welt 30: 1687–1691PubMedGoogle Scholar
  38. 38.
    Oppel F, Schramm J, Schirmer M (1977) Results and complicated courses after surgery for lumbar disc herniations. In: Wüllenweber R, Brock M, Hamer J, et al, (eds) Advances in Neurosurgery, vol 4. Springer, New York, pp 36–51Google Scholar
  39. 39.
    Oppenheim H, Krause F (1909) Über Einklemmung bzw. Strangulation der cauda equina. Dtsch Med Wochenschr 35: 697–700Google Scholar
  40. 40.
    Probst C (1989) Lumbale Diskushernien: Mikrochirurgie–Ja oder Nein? Neurochirurgie 32: 172–176Google Scholar
  41. 41.
    Sachs BL, Vanharanta H, Spivey MA, Guyer RD (1987) Dallas discogram description–a new classification of CT/discography in low-back disorders. Spine 12: 287–293PubMedCrossRefGoogle Scholar
  42. 42.
    Salenius P, Laurent LE (1977) Results of operative treatment of lumbar disc herniation. A survey of 886 patients. Acta Orthop Scand 48: 630–634PubMedCrossRefGoogle Scholar
  43. 43.
    Schepelmann F, Greiner L, Pia HW (1977) Complications following operation of herniated lumbar discs. Adv Neurosurg 4: 52–54CrossRefGoogle Scholar
  44. 44.
    Nyström B (1987) Experience of microsurgical compared with conventional technique in lumbar disc operations. Acta Neurol Scand 76: 129–141PubMedCrossRefGoogle Scholar
  45. 45.
    Schmorl G, Junghanns H (1932) Die gesunde und kranke Wirbelsäule im Röntgenbild. Pathologisch-anatomische Untersuchungen. Thieme, Leipzig, pp 89–122Google Scholar
  46. 46.
    Schneiderman G, Flannigan B, Kingston S, Thomas J (1987) Magnetic resonance imaging in the diagnosis of disc degeneration. Spine 12: 277–281CrossRefGoogle Scholar
  47. 47.
    Schramm J, Oppel F, Umbach W, Wüllenweber R (1978) Komplizierte Verläufe nach lumbalen Bandscheibenoperationen. Nervenarzt 49:26–33Google Scholar
  48. 48.
    Silvers HR (1988) Microsurgical versus standard lumbar discectomy. Neurosurgery 22: 837–841PubMedCrossRefGoogle Scholar
  49. 49.
    Spangfort EV (1972) The lumbar disc herniation. A computer-aided analysis of 2504 operations. Acta Orthop Scand Suppl 142: 1–95PubMedGoogle Scholar
  50. 50.
    Steinke CR (1918) Spinal tumors: Statistics on a series of 330 collected cases. J Nerv Ment Dis 47: 418–426CrossRefGoogle Scholar
  51. 51.
    Stolke D, Sollmann WP, Seifert V (1989) Intra-and postoperative complications in lumbar disc surgery. Spine 14: 56–59PubMedCrossRefGoogle Scholar
  52. 52.
    Stookey B (1928) Compression of spinal cord due to ventral extradural chondromas; diagnosis and surgical treatment. Arch Neurol Psychiatry (Chicago) 20: 275–291CrossRefGoogle Scholar
  53. 53.
    Thomalske G, Galow W, Ploke G (1977) Critical comments on a comparison of two series (l000 patients each) of lumbar disc surgery. In: Wüllenweber R, Brock M, Hamer J, et al, (eds) Advances in Neurosurgery, vol 4. Springer, Berlin Heidelberg New York, pp 22–27Google Scholar
  54. 54.
    Thomas AMC, Afshar F (1987) The microsurgical treatment of lumbar disc protrusion. J Bone Joint Surg Br 69: 696–698PubMedGoogle Scholar
  55. 55.
    Tullberg T, Isacson J, Weidenhielm L (1993) Does microscopic removal of lumbar disc herniation lead to better results than the standard procedure? Spine 18: 24–27PubMedCrossRefGoogle Scholar
  56. 56.
    Vogt KH (1974) Ergebnisse nach lumbaler Bandscheibenoperation. Z Orthop Ihre Grenzgeb 112: 821–822PubMedGoogle Scholar
  57. 57.
    Weber H (1978) Lumbar disc herniation. J Oslo City Hosp 28:33–64Google Scholar
  58. 58.
    Weber H (1983) Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine 8: 131–140PubMedCrossRefGoogle Scholar
  59. 59.
    Weber U, Sparmann M, Greulich A (eds)(1992) Orthopädische Mikrochirurgie. Thieme, StuttgartGoogle Scholar
  60. Weir BKA (1979) Prospective study of loo lumbosacral discectomies. J Neurosurg 50: 283–289PubMedCrossRefGoogle Scholar
  61. 61.
    Wildförster U (1991) Intraoperative Komplikationen während lumbaler Bandscheibenoperationen. Neurochirurgie 34: 53–56Google Scholar
  62. 62.
    Wilkinson HA (ed) (1992) The failed back syndrome, 2nd edn. Harper and Rowe, New YorkGoogle Scholar
  63. 63.
    Williams RW (1978) Microlumbar discectomy. A conservative surgical approach to the virgin herniated lumbar disc. Spine 3: 175–182PubMedCrossRefGoogle Scholar
  64. 64.
    Williams RW (1986) Microlumbar discectomy. A 12-year statistical review. Spine 11: 851–852PubMedCrossRefGoogle Scholar
  65. 65.
    Wilson DH, Kenning J (1979) Microsurgical lumbar discectomy: preliminary report of 83 consecutive cases. Neurosurgery 42: 137–140CrossRefGoogle Scholar
  66. 66.
    Wilson DH, Harbaugh R (1981) Microsurgical and standard removal of the protruded lumbar disc: a comparative study. Neurosurgery 8: 422–427PubMedCrossRefGoogle Scholar
  67. 67.
    Wilson DH, Harbaugh R (1982) Lumbar discectomy: a comparative study of microsurgical and standard technique. In Hardy RW (ed) Lumbar disc disease. Raven Press, New York, pp 147–156Google Scholar
  68. 68.
    Wiltse LL, Fonseca AS, Amster J, Dimartino P, Ravessoud A (1993) Relationship of the dura, Hofmann’s ligaments, Bat-son’s plexus and a fibrovascular membrane lying on the posterior surface of the vertebral bodies and attaching to the deep layer of the posterior longitudinal ligament. Spine 18a030-1043Google Scholar
  69. 69.
    Yasargil MG (1977) Microsurgical operation of herniated lumbar disc. In: Wüllenweber R, Brock M, Hamer J, et al, (eds) Advances in Neurosurgery, vol 4. Springer, Berlin Heidelberg New York, pp 81–82Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • H. M. Mayer

There are no affiliations available

Personalised recommendations