Stabilizing spinal fusion following herniated disk removal without fusion.

Abstract

This report concerns 43 patients previously operated on for herniated disks within my community, in which such surgery has been largely controlled by the neurosurgeon. Disk removal without spinal fusion had been done. The 43 patients presented themselves with continued disability and a definite pattern of symptoms. I believe that the adverse findings in these cases were attributable to four mistaken concepts regarding the disk syndrome. These patients had been treated in the belief that a myelogram is always in order, fusion has no place in low back disability, curettage of the intervertebral space should be carried out, and ambulation without support should be urged immediately after operation. GROUPS OF PATIENTS These 43 patients fall into three groups. The first group consists of four patients in whom some disorder other than disk herniation was present; the second group includes 27 patients who had some improvement after excision of herniated material;