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The lumbar intervertebral disk. A clinicopathological correlation based on over 100 laminectomies.

The exact etiology and pathogenesis of intervertebral disk herniation remains unknown. However, man's erect posture and the process of aging are known to produce certain changes in disk structure. The semiliquid gel (nucleus pulposus) loses much of its highly elastic nature and becomes more fibrotic. Degeneration occurs by an increased deposition of collagen fibrils and there is a loss of nucleus water content and mucoid substance. 1 The nucleus, as a three-dimensional lattice gel structure of a protein-polysaccharide complex, is prone to degeneration with aging. 2 Microscopic evaluation of disks removed at surgery has not been able to correlate clinical symptoms and signs since they show only variable amounts of fibrocartilaginous tissue. 3 It has been my personal observation in experiences with over 100 laminectomies in the lum bar region that simple gross examination of the lesional tissue offers a better correlation with the clinical findings. Method The usual clinical