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History of disc surgery

Lumbar discectomy was first performed in the 1938 in the United States by a neurosurgeon.  Diagnoses at that time were made by symptoms and  Xrays. Doctors often thought that the herniated disc was a cartilage tumor because diagnoses could not be ascertained as accurately as in the 1990s.  So, early surgeries were often exploratory and  required wide exposures of the anatomy to be sure that everything was checked and that, if a tumor were present, there was enough room to take out  the the tumor.  The procedure was lumbar discectomy and was a limited version of an extensive spine procedure called lumbar laminectomy– an operation that had been around  for the previous 25 years.  Lumbar laminectomy involves the “unroofing” of the spine and exposure of all the anatomy inside.  Laminectomy removes this “roof” and spinous  processes eliminating the attachments of important stabilizing spinal musculature increasing the chances of spinal instability.

With the advent of  accurate neurodiagnostic studies like CAT scans, discography, and MRI scans,  spine surgery has taken a leap forward allowing for a more accurate diagnosis and more specific surgery to be done. The introduction of lasers and endoscopes in medicine has permitted the means to treat the disease and avoid potentially harmful nerve root retraction.

 

Typical symptoms of disc disease

  • Back pain with spread of the pain to one or both buttocks
  • Back pain with spread of the pain to one or both buttocks
  • Leg pain which can start at the upper thigh and “radiate” down to the foot or toes
  • Back pain which stops you from walking– maybe a history of stenosis
  • A weak foot or difficulty walking– even with NO pain!!
  • Pain into the groin but NO hernia or pulled muscle
  • Return of symptoms you were told was from a strained back
  • Back pain which keeps you awake
  • Previous surgery with a return of symptoms– “just like before”

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