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[Surgical therapy of lumbar disk herniation in 6 815 cases].

OBJECTIVE
To explore the surgical therapy for lumbar disc herniation (LDH).


METHODS
Under local anesthesia by blocking the posterior branches of spinal nerves, 3 surgical approaches were adopted in 6 815 LDH cases, namely discectomy by lateral and interlamina access, double fenestration and enhanced decompression for broad central LDH, and removal of nucleus pulposus with small incision and fenestration.


RESULTS
Follow-up study was conducted in 5 324 cases for the duration varying from 6 months to 14 years, averaging 6.3 years. Excellent results were achieved in 4 260 cases (80.02%), good in 855 cases (16.06%) with another 209 cases (3.92%) showing symptomatic improvement. X-ray examination in these cases revealed narrowed intervertebral spaces of different degrees without lumbar instability or spondylolisthesis.


CONCLUSION
In comparison with conventional approaches, the 3 surgical approaches for LDH management may preserve the utmost integrity of the posterior lumbar structures and cause less traumatic injuries with shortened operation time and quick recovery.