Factors Affecting the Results of Surgery for Prolapsed Lumbar Intervertebral Disc

Abstract

The clinical and operative findings in 320 patients with prolapsed lumbar intervertebral discs are described. The level of the lesion was correctly predicted on clinical grounds in 70 per cent of cases, but no single sign was found to be a reliable indication of the level. Prolapsed discs at 2 levels were found in 10 per cent of patients and it is suggested that both the L4/5 and the L5/S1 spaces should always be explored at operation. The long-term post-operative results are presented in 214 of the patients. Excellent results were obtained in 68 per cent of patients, good results in 14 per cent, poor results in 9 per cent and bad results in 8.5 per cent. Operation was less successful in patients over 40 years of age, in heavy manual workers, and in those with continuous sciatica for more than 1 year. It is suggested that a readiness to operate at an earlier stage in resistant cases would significantly improve the results of surgery.