Results of intervertebral diskectomy without fusion at L4-5 versus L5-S1.

The results of diskectomy without fusion at L4-5 were compared with those at L5-S1. Strict indications for surgery had been applied to each group. Evaluation was carried out using the Oswestry Disability scale, as well as a modified Smiley-Webster scale, and a subjective improvement rating scale, as well as documenting work status, whether any future surgery was required, and other factors. Results were placed into categories based on these evaluation methods and were analyzed statistically. Average follow-up was 51 months with a minimum of 24 months. Overall excellent and good results occurred in 81% of patients in both groups. No difference in reoperation rate was detected between the two groups. Women were more likely to undergo a subsequent procedure, usually fusion. Equally satisfactory results can be obtained at L4-5 and L5-S1 if strict selection criteria are used.