Results of Two Kinds of Disc Surgery
How does surgery to remove a disc affect low back pain? Doctors in Japan followed 40 patients for up to 54 months after two different kinds of surgery to find out. The patients were divided into two groups. The groups were similar in age and had an equal number of men and women. No one was on worker's compensation. All patients had a disc herniation at one level in the lumbar spine. They had low back pain and leg pain (sciatica) that didn't get better with treatment.
Group one had the standard disc removal with an open incision called open discectomy. Group two had microsurgery. A small opening was made just large enough to insert a special tool with a tiny TV camera on the end. This method is called microendoscopic discectomy.
In all cases the loose disc material was removed. Nothing else was cut or taken out. Pressure on the spinal nerve root was relieved with both operations. Leg pain went away in all patients. For some patients pain relief happened right away. For others it decreased slowly over a month's time.
Back pain was also improved for all but three of the 40 patients. Everyone who was working before the operation went back to work within two months of the surgery. All patients in both groups had about the same results in the same amount of time.
The authors report on previous studies that suggest disc removal helps with leg but not back pain. Their own study doesn't support those findings. Removal of a herniated disc provided quick relief of both sciatica and low back pain. They suggest that the difference was that no patients in this study were on worker's compensation.
Tomoaki Toyone, MD, et al. Low Back Pain Following Surgery for Lumbar Disc Herniation. In The Journal of Bone and Joint Surgery . May 2004. Vol. 86-A. No. 5. Pp. 893-896.