추간 원판 탈출증 1500 수술예의 임상적 관찰

Abstract

[한글]

[영문]

Intervertebral disc disease, encountered in term of its life history, represents

one of the most complexing medico-surgical disorders. The discovery by Mixter and

Barr in 1934, that an intraspinal protrusion of the intervertebral disc was

sometimes the cause of lumbago and sciatica, was outstandingly important because it

might provide a rational for the treatment of backache.

The author has reviewed 1500 cases of disc furgery performed at Yonsei

University, Severance Hospital from 1950 to 1971.

A contrast myelograhpy was carried out routinely and the dye was attempted to

remove as much as possible. Surgical treatment was underwent by laminectomy,

partial hemi-or total, for the thoracic and lumbar discs and Cloward's anterior

approach for cervical discs invariably.

Conclusion:

1. Among the 1500 disc surgeries 90.2% were lumbar disc lesions; thoracic 0.1%

and cervical 9.7%. The percentile of disc herniation between L4-5 vertebrae was

62%;27% between L5-S1 vertebrae. 24% of lumbar intervertebral disc herniations

disclosed multiple lesions.

2. A contrast myelography is an invaluable prodedure for the diagnosis of a

herniation of the nucleus pulpo년. It is a considerably safe procedure with minimal

complecations when performed carefully.

3. For a central disc herniation surgical approach from both sides may preferably

render a better result.

4. In cases when the nucleus pulposus being protreded way laterally a

decompression of the nerve root is mandatory in the foraminal and the disc

interspace.

5. The posterior approach for the thoracic disc herniation may render a

considerable damage to the spinal cord with subsequent paraparesis. The

anterolateral or posterolateral procedure may give a better result.

6. 97.7% of lumber disc surgery disclosed from an improvement to recovery.

7. The anterior approach for the cervical intervertebral discs gives a better

result; 98% of the surgeries disclosed an improvement to recovery.