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In a continuous series of 770 patients with a herniated disk treated by chemonucleolysis, 16 patients had herniation of the L3-L4 disk (2.1%). There were no complications, and none of these 16 patients had open surgery after the initial treatment. A follow-up study was performed after 39 months (range, six to 80 months) in 15 patients. Three patients were for the most part satisfied and 12 patients were fully satisfied with the result of treatment. Residual pain was minor in most patients. Roentgenographic signs of increased disk degeneration were seen in six patients, and reexpansion of the disk to some degree was noted in four patients. Chemonucleolysis is effective for treatment of the herniated L3-L4 disk.

A retrospective study was conducted in 60 patients with stab or gunshot wounds to assess whether selective management is also justified if personnel involved has not had a great deal of experience. With selective management the results of the physical examination determine whether a laparotomy will or will not be performed.